Sequential cataract surgeries in a patient with a left ventricular assist device (LVAD)

Abstract

The population of patients on left ventricular assist devices (LVADs) has increased significantly since the 1990s, and with it, need for non-cardiac elective surgeries. Presence of an LVAD or heart failure, however, can cause physicians to perceive these patients to be at prohibitively high risk for elective surgery. Nevertheless, as one of the most common causes of poor vision in the elderly, cataracts can significantly limit improvements in quality of life that a patient may have otherwise gained from LVAD support. We describe the case of a 62-year-old man with an LVAD who underwent two uncomplicated sequential cataract surgeries following extensive cardiology evaluations and intraoperative monitoring by anaesthesia without intravenous sedation. The patient reported significant improvement in visual acuity and quality of life. Our case demonstrates the potential benefits of conducting cataract surgery relatively early in the disease course in patients with LVAD devices.

Ophthalmic Surgery in Patients with Left Ventricular Assist Devices

“…Our series included seven LVAD patients who underwent 10 ophthalmic surgeries. Other reports in the literature cite the management of up to three LVAD patients having four cataract surgeries [5, 6]. In our experience, these procedures can be safely performed in a resource limited ambulatory facility, such as an ambulatory surgery center, provided a close working relationship with the VAD center is in place.…”