title: Laparoscopic splenectomy in a patient with a Heartmate(®) II left ventricular assist device.
abstract: BACKGROUND
  Since the publication of the REMATCH trial results, it is estimated that almost 5 million Americans have been found to have heart failure. Limited availability of organs for transplantation, coupled with wider selection criteria for destination therapy, has resulted in a substantial increase in the number of patients with permanently assisted circulation. Given the high rate of complications related to circulatory assist devices, it is expected that these patients will be undergoing noncardiac surgical procedures more commonly.
  
  
  METHODS
  We describe a laparoscopic splenectomy in a patient supported with a Heartmate II left ventricular assist device. Using this case as a model, we discuss hemodynamic changes associated with pneumoperitoneum and anesthesia induction. Additionally, an extensive literature search was performed to asses the frequency of laparoscopic procedures performed on patients with circulatory support.
  
  
  RESULTS
  Laparoscopic splenectomy was performed without significant hemodynamic changes. To our knowledge, this is the first laparoscopic splenectomy performed in a patient with this mode of circulatory support.
  
  
  CONCLUSIONS
  Laparoscopic procedures can safely be performed in patients with compensated heart failure, who are supported with ventricular assist devices.
authors.affiliation: Division of Cardiothoracic Surgery, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Gordan
authors.initials: G
authors.lastname: Samoukovic
authors.forename: Melina
authors.initials: M
authors.lastname: Vassiliou
authors.forename: Nadia
authors.initials: N
authors.lastname: Giannetti
authors.forename: Salman
authors.initials: S
authors.lastname: Al-Sabah
authors.forename: Vynka
authors.initials: V
authors.lastname: Lash
authors.forename: Renzo
authors.initials: R
authors.lastname: Cecere
mesh_terms: D006353:Heart-Assist Devices; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D013156:Splenectomy / Q000379:methods*