Related Experiment Video
Updated: Dec 13, 2025
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Anesthetic management of a patient with left ventricular assist device undergoing robotic laparoscopic prostatectomy:
Andrew J B Pisansky1, Nelson Burbano-Vera2, Matthias F Stopfkuchen-Evans3
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA. AJBPisansky@gmail.com.
Background:
Patients with left ventricular assist devices (LVAD) require specific anesthetic and hemodynamic considerations. We report the specific anesthetic preparation and management in this scenario.
Case Presentation:
We present the case of a 66-year-old male with a HeartMate II LVAD undergoing robotic prostatectomy for prostate cancer in the steep Trendelenburg position. We employed central venous and radial arterial access, LVAD pump parameters, near-infrared sensor of cerebral oximetry, and transesophageal echocardiography for monitoring. Hemodynamics were managed with nicardipine, dobutamine, epinephrine, and phenylephrine during abdominal insufflation, operative positioning, and desufflation. The patient had a successful procedure, was discharged on postoperative day 2, and achieved surgical cure of his prostate cancer.
Discussion:
By presenting the first detailed account of anesthetic management in this scenario, we provide a clinical vignette for use by the clinical anesthesiologist in his or her preparation prior to caring for this type of patient.
