Key result
Perioperative management of a patient with a HeartMate II LVAD undergoing laparoscopic ileo-colectomy was successful, highlighting the utility of intraoperative TEE and limitations of standard monitoring.
Case Report (n=1)
Demonstrates the feasibility of major laparoscopic abdominal surgery in patients with continuous-flow LVADs when managed with a multidisciplinary approach and appropriate intraoperative monitoring.
Hypothesis-generating for TEE use in LVAD patients during laparoscopy; prospective studies needed before practice change.
The use of mechanical circulatory support devices as a bridge to transplant or destination therapy decreases mortality, improves quality of life, and functional status. The paucity of clinical data and the challenges faced by noncardiac anesthesiologists warrant us to present the perioperative care of a patient with a HeartMate II (Thoratec Corp. Pleasanton, CA, USA) left ventricular assist device (LVAD), who underwent a successful major laparoscopic abdominal surgery. Key issues highlighted are the limitations of oxygen saturation (SpO(2)) monitoring, accuracy of blood pressure (BP) measurement, and the potential usefulness of intraoperative transesophageal echocardiography (TEE). The hemodynamic changes, impact on the LVAD function during laparoscopic surgery, and the multidisciplinary approach are addressed.
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Sathishkumar et al. (2012) conducted a case report in Patient with a left ventricular assist device (LVAD) undergoing laparoscopic abdominal surgery (n=1). Perioperative management during laparoscopic ileo-colectomy was evaluated. Perioperative management of a patient with a HeartMate II LVAD undergoing laparoscopic ileo-colectomy was successful, highlighting the utility of intraoperative TEE and limitations of standard monitoring.
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