Insertion of ventricular assist device

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Insertion of ventricular assist device
Anesthesia type
Airway
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Monitors
Primary anesthetic considerations
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Intraoperative
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A ventricular assist device (VAD) is a pump designed to assist the left or right ventricle in severe heart failure. These devices may help the left ventricle (LVAD), the right ventricle (RVAD), or bilateral ventricles (BiVAD). The device may be placed as a permanent solution or as a bridge to cardiac transplant.

Overview

Indications

Severe heart failure

Surgical procedure

LVAD

Surgeons will perform sternotomy for exposure and either cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO). The device is placed at the apex of the left ventricle with an outflow graft anastomosed to the ascending aorta.

Preoperative management

Patient evaluation

System Considerations
Airway
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References