Review article
Postoperative Management of Patients after VAD Implementation
Nikola Bradić
; Department of Anesthesiology and Intensive Care, University Hospital Dubrava, Zagreb, Croatia;
Mislav Planinc
; Department of Cardiac Surgery, University Hospital Dubrava, Zagreb, Croatia
Stjepan Barišin
; Department of Anesthesiology and Intensive Care, University Hospital Dubrava, Zagreb, Croatia;
Abstract
After the implantation of the left ventricular assisted device (LVAD), patients are admitted in intensive care unit (ICU). During the period of first several days, the goal of the postoperative care is to stabilize the patients’ hemodynamics. Monitoring the continuous cardiac output, filling volumes and outflow resistance is necessary for the proper functioning of the pump. The use of pulmonary artery catheter and the transesophageal echocardiography are primary procedures. During the operation of the left ventricular support, the measuring of proper ventricular function and the early recognition of its dysfunction is important for a positive outcome. Further potential complications in connection with these patients are an increased risk of hemorrhage and thromboembolism. The infection of drivelines and devices in the early postoperative period occurs in up to 40 % of these patients. In case of a cardiac arrest, a special procedure has to be performed in patients in whom LVAD was implanted. Finally, we have shown the anesthesiologic management in cases when patients with LVAD have to undergo noncardiac surgery.
Keywords
LVAD; hemodynamics; TEE; LVAD; noncardiac surgery
Hrčak ID:
66341
URI
Publication date:
11.3.2011.
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