Experience with noncardiac surgery in destination therapy left ventricular assist devices patients.
Continuous flow left ventricular assist devices (CF-LVAD) are increasing the life expectancy of patients with advanced heart failure, with these patients undergoing more noncardiac operations after implantation. The purpose of this study was to determine the safety of noncardiac operations in destination therapy CF-LVAD patients. In a retrospective study of 110 CF-LVAD patients, we reviewed 36 patients who underwent 63 noncardiac operations 315.1 ± 333.5 days after LVAD placement. Fifty-four (84%) operations were elective and 10 were emergent. The mean age of the cohort was 61.4 ± 11.4 years, with the majority (81%) being men. Most patients (n = 24, 38%) underwent total abdominal operation. Of the 36 patients in the study, 23 (63.8%) patients required one surgical procedure, and 13(36.1%) patients underwent more than one procedure. Six critically ill patients (16%) of 37 expired within 30 days after emergent operation. Our study demonstrates overall good clinical outcomes with minimal intraoperative complications in LVAD patients undergoing noncardiac surgeries, except an increased propensity for intra- and postoperative transfusion of blood products because of complex coagulopathies.
Center for Heart Transplant and Assist Devices, Oak Lawn, IL 60453, USA. geetha.bhat@advocatehealth.com
Geetha
G
Bhat
Shivani
S
Kumar
Ashim
A
Aggarwal
Sunil
S
Pauwaa
German
G
Rossell
Sudha
S
Kurien
Anup
A
Kumar
Pat S
PS
Pappas
Antone
A
Tatooles
D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology; D001803:Blood Transfusion; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*; D013927:Thrombosis; D013997:Time Factors; D016896:Treatment Outcome; D014655:Vascular Resistance
D000925:Anticoagulants