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Anesthetic Management of Left Ventricular Assist Device Exchange in a Patient with Intracranial Hemorrhage

Nevriye Salman1, Sınan Sabit Kocabeyoğlu2, Ülkü Sabuncu1

  • 1Department of Anesthesia and Reanimation, SBU Yüksek İhtisas Ankara Research and Training Hospital, Ankara, Turkey.

The Journal of Tehran Heart Center
|August 4, 2020
PubMed

Insights

Heart transplantation is limited by organ donor shortages. Left ventricular assist devices (LVADs) improve survival in heart failure patients, but require specialized anesthetic care for complications like intracranial hemorrhage during device exchange.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Neurosurgery

Background:

  • Heart transplantation is the gold standard for end-stage heart failure but faces limitations due to organ donor scarcity.
  • Left ventricular assist devices (LVADs) serve as a crucial bridge to transplantation, increasingly used to reduce mortality despite associated morbidities.

Observation:

  • A 60-year-old male patient with an LVAD presented with neurological deficits including right hemiparesis, dysphasia, and facial paralysis.
  • The patient's condition was attributed to intracranial hemorrhage secondary to LVAD thrombosis.

Findings:

  • The case highlights the critical need for experienced anesthetic management in patients with LVADs experiencing severe complications.
  • Successful anesthetic management was achieved during LVAD exchange in a patient with intracranial hemorrhage.

Implications:

  • This case underscores the importance of multidisciplinary care and specialized anesthetic protocols for managing complex LVAD-related neurological emergencies.
  • Improved understanding of anesthetic considerations can enhance outcomes for LVAD patients undergoing device revision or exchange.

Keywords:
AnesthesiaHeart-assist devicesIntracranial hemorrhages

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