Perioperative Management of Patients With Left Ventricular Assist Devices Undergoing Noncardiac Procedures: A Survey of Current Practices

• Published in: Journal of cardiothoracic and vascular anesthesia 2015-02, Vol.29 (1), p.17-26
• Main Authors: Sheu, Richard, MD, Joshi, Brijen, MD, High, Kane, MD, Thinh Pham, Duc, MD, Ferreira, Renata, MD, Cobey, Frederick, MD, MPH, FASE
• Format: Article
• Language: English
• Subjects: anesthesia; Anesthesia & Perioperative Care; Anesthesia - methods; Anesthesia - standards; Anesthesiology - methods; Anesthesiology - standards; Critical Care; Data Collection - methods; Disease Management; endoscopy; Heart-Assist Devices - standards; Humans; left ventricular assist device; LVAD; monitors; noncardiac surgery; Perioperative Care - methods; Perioperative Care - standards; Physicians - standards; Societies, Medical - standards; survey
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2014.07.001

Objectives To describe perioperative management of patients with left ventricular assist devices (LVAD) in noncardiac procedures. Design Survey of (1) respondent demographic characteristics, (2) anesthetic practices for LVAD patients having endoscopies, and (3) low-risk surgeries requiring general anesthesia. Setting Internet-based. Participants Society of Cardiovascular Anesthesiologists membership. Interventions None. Measurements and Main Results Inpatient endoscopic procedures were done mainly in the endoscopy suite (71.7%) by a solo practitioner or 1:1 staffing ratio 59% of the time. LVAD-specific support personnel were present in more than 80% of all procedures. Both endoscopy and surgical patients used post-anesthesia recovery units and intensive care units for recovery; however, compared with endoscopy patients, surgical patients recovered in the ICU more frequently (45.5% v 29.1%, p