Perfusionist's role in long-term ventricular assist device

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Perfusion Science

Background:

• Ventricular assist devices (VADs) are critical for managing advanced heart failure (Stage D).
• Perfusionists play a vital role in VAD implantation, ensuring hemodynamic stability and oxygen delivery.
• Standardized protocols are essential for successful VAD procedures.

Purpose of the Study:

• To describe the institutional perfusion protocol for left ventricular assist device (LVAD) implantation.
• To characterize intraoperative perfusion parameters during LVAD procedures at a Latin American center.

Main Methods:

• Retrospective observational cohort study.
• Inclusion of all patients undergoing LVAD implantation at a Colombian referral center.
• Descriptive statistical analysis of intraoperative data.

Main Results:

• 33 patients underwent LVAD implantation; median age 54 years, 51.52% male.
• Ischemic cardiomyopathy was the most common etiology (27.27%).
• Median cardiopulmonary bypass time was 153 minutes, with median lactate levels of 1.8 mmol/L and cardiac index between 2.3-2.6 L/min/m².

Conclusions:

• Cardiopulmonary perfusion is vital for successful long-term LVAD implantation in advanced heart failure.
• Optimal intraoperative management, including controlled temperature, low lactate, and appropriate cardiac index, is essential.
• Standardized strategies and perfusionist expertise are critical for advanced heart failure management with LVADs.