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Facilitating noncardiac surgery for the patient with left ventricular assist device: A guide for the anesthesiologist


1 Department of Anaesthesiology, Singapore General Hospital, 1 Hospital Drive, Singapore 169608, Singapore
2 Department of Anaesthesiology, Singapore General Hospital, 1 Hospital Drive, Singapore 169608; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore, 5 Hospital Drive, Singapore 169609, Singapore

Correspondence Address:
Nian-Chih Hwang
Department of Anaesthesiology, Singapore General Hospital, 1 Hospital Drive, Singapore 169608
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_239_17

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Year : 2018  |  Volume : 21  |  Issue : 4  |  Page : 351-362

 

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The introduction of left ventricular assist device (LVAD) has improved survival rates for patients with end-stage heart failure. Two categories of VADs exist: one generates pulsatile flow and the other produces nonpulsatile continuous flow. Survival is better for patients with continuous-flow LVADs. With improved survival, more of such patients now present for noncardiac surgery (NCS). This review, written for the general anesthesiologists, addresses the perioperative considerations when the patient undergoes NCS. For best outcomes, a multidisciplinary approach is essential in perioperative management of the patient.






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1 Department of Anaesthesiology, Singapore General Hospital, 1 Hospital Drive, Singapore 169608, Singapore
2 Department of Anaesthesiology, Singapore General Hospital, 1 Hospital Drive, Singapore 169608; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore, 5 Hospital Drive, Singapore 169609, Singapore

Correspondence Address:
Nian-Chih Hwang
Department of Anaesthesiology, Singapore General Hospital, 1 Hospital Drive, Singapore 169608
Singapore
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_239_17

Rights and Permissions

The introduction of left ventricular assist device (LVAD) has improved survival rates for patients with end-stage heart failure. Two categories of VADs exist: one generates pulsatile flow and the other produces nonpulsatile continuous flow. Survival is better for patients with continuous-flow LVADs. With improved survival, more of such patients now present for noncardiac surgery (NCS). This review, written for the general anesthesiologists, addresses the perioperative considerations when the patient undergoes NCS. For best outcomes, a multidisciplinary approach is essential in perioperative management of the patient.






[FULL TEXT] [PDF]*


        
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