Key result
Invasive arterial monitoring and multidisciplinary coordination enable successful pheochromocytoma resection in an LVAD patient.
Why the study?
Continuous flow LVADs increase sympathetic tone and make traditional assessment of sympathetic tone challenging, complicating the perioperative management of pheochromocytoma resection.
Case Report (n=1)
Invasive arterial line monitoring and multidisciplinary coordination are crucial for the successful perioperative management of pheochromocytoma in patients with continuous flow LVADs.
May support arterial monitoring in rare LVAD-pheochromocytoma cases; leaves open need for prospective validation before wider use.
Current generation LVADs provide continuous blood flow which has been shown to increase sympathetic tone. Pheochromocytoma is a rare neuroendocrine tumor which classically presents with episodic hypertension, palpitations and headaches. Careful perioperative management with alpha blockade is required to prevent cardiovascular complications, specifically hypertensive crisis. Here we present a description of perioperative management of pheochromocytoma in a patient with a continuous flow LVAD. Traditional assessment of sympathetic tone is challenging in LVAD patients due to the presence of continuous circulatory flow. Invasive management via an arterial line was useful in perioperative management, allowing for accurate circulatory monitoring and hemodynamic control. Finally, close coordination of multiple specialties including advanced heart failure, anesthesia, and endocrinology was vital to the positive outcome in this case.
No takes yet. Share an insight, caveat, or question.
Albulushi et al. (2020) conducted a case report in Pheochromocytoma in a patient with a continuous flow LVAD (n=1). Perioperative management with alpha blockade and invasive arterial line monitoring was evaluated on Positive outcome (successful perioperative management). Invasive management via an arterial line and multidisciplinary coordination allowed for successful perioperative management of pheochromocytoma resection in a patient with a continuous flow LVAD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: