[Anesthetic management of patients undergoing implantation of left ventricular assist system]

We examined the anesthetic management of six patients with end-stage dilated and hypertrophic cardiomyopathy for implantation of left ventricular assist system. Although anesthesia was induced only with fentanyl or with combination of fentanyl and diazepam, hemodynamic changes after the anesthetic induction were variable and preoperative evaluation of left ventricular ejection fraction did not predict the hemodynamic changes. After the weaning from cardiopulmonary bypass, the right ventricular support by catecholamines, such as dopamine and dobutamine, and phosphodiesterase III inhibitors, such as amrinone, and pulmonary vasodilation by inhalation of nitric oxide were useful to maintain volume loading to the left ventricular assist system.