Anesthetic Management for Left Ventricular Assist Device Implantation Without Using Cardiopulmonary Bypass: Case Series

Karaca, Nursen; Şahutoğlu, Cengiz; Kocabas, S.; Orhaner, B.T.; Aşkar, Fatma Zekiye; Ertugay, Serkan; Engin, Çağatay; Yağdı, Tahir; Özbaran, Mustafa

doi:10.1016/j.transproceed.2015.04.074

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…The implantation of LVADs with a thoracotomy approach can be done on-pump and off-pump. The median sternotomy requires a cardiopulmonary bypass (CPB) pump, and the LT approach can be achieved with or without CPB [21]. During a preoperative evaluation of these patients, bleeding diathesis, renal dysfunction, and pulmonary compromise are some of the biggest concerns.…”

Section: Anesthetic Management Of Left Ventricular Assist Device Impl...mentioning

confidence: 99%

Lateral thoracotomy versus sternotomy for left ventricular assist device implantation

Zubair

Brovman

2022

Current Opinion in Anaesthesiology

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Purpose of reviewTraditionally, left ventricular assist devices (LVADs) are implanted via the standard median sternotomy approach. However, a left thoracotomy approach has been purported to offer physiologic benefits. As a result, utilization of the left thoracotomy for LVAD placement is increasing globally, but the benefits of this approach versus sternotomy are still evolving and debatable. This review compares the median sternotomy and thoracotomy approaches for LVAD placement.Recent findingsRecent meta-analyses of LVAD implantation via thoracotomy approach suggest that the thoracotomy approach was associated with a reduced incidence of RVF, bleeding, hospital length of stay (LOS), and mortality [1▪▪,2▪▪]. No difference in stroke rates was noted. These results offer support as to the feasibility of a thoracotomy approach for LVAD implantation but also highlight its potential superiority over sternotomy.SummaryThe most recent literature supports the use of lateral thoracotomy for placement of left ventricle assist devices compared to median sternotomy. Long-term outcomes from lateral thoracotomy are still unknown, however, short-term results favor lateral thoracotomy approaches for LVAD implantation. While the conventional median sternotomy approach was the original operative technique of choice for LVAD implantation, lateral thoracotomy is quickly emerging as a potentially superior technique.

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Section: Anesthetic Management Of Left Ventricular Assist Device Impl...mentioning

confidence: 99%