Noncardiac surgery in long-term implantable XXXX recipients.

@entity1 @entity3124 @entity712 @entity1002
OBJECTIVE: The authors describe their experience with @entity1002 ( @entity1002 ) recipients undergoing noncardiac surgery and delineate surgical, anesthetic, and logistic factors important in the successful intraoperative management of these @entity1 . SUMMARY BACKGROUND DATA: Left ventricular assist-devices have become part of the armamentarium in the treatment of end-stage @entity712 . As the numbers of @entity1 chronically supported with long-term implantable devices grows, general surgical problems that are commonly seen in other hospitalized @entity1 are becoming manifest. Of particular interest is the intraoperative management of @entity1 undergoing elective noncardiac surgical procedures. METHODS: The anesthesia records and clinical charts were reviewed for eight ventricular assist-device recipients undergoing general surgical procedures between August 1, 1990 and August 31, 1994. RESULTS: A total of 12 procedures were performed in 6 @entity1 and 2 @entity1 averaging 52.7 years of age. Mean time elapsed from device implantation to operation was 68 +/- 35 days. Conventional inhalational and intravenous anesthetic techniques were well tolerated in these @entity1 undergoing diverse surgical procedures. No perioperative mortality was observed. Five of eight @entity1 went on to successful cardiac transplantation. CONCLUSIONS: Hemodynamic recovery after @entity1002 insertion has defined a new group of @entity1 who develop noncardiac surgical problems often seen in other @entity3124 @entity1 . Recognition of the unique potential problems that the @entity1002 recipient may encounter in the perioperative period--in particular @entity1 positioning, device limitations, and fluid and inotropic management--will ensure an optimal surgical outcome for @entity1002 recipients undergoing noncardiac surgery.
