Effective Illustration of Decommissioning of Left Ventricular Assist Device after Bridge-to-Recovery by Hybrid Minimally-Invasive Tactic: Anesthesia SubstancesThay Yu Jia*, Shah Shitalkumar S and Kothandan Harikrishnan
Department of Anaesthesiology, Singapore General Hospital, Singapore
- *Corresponding Author:
- Thay Yu Jia
Associate Consultant, Department of Anaesthesiology
Singapore General Hospital, Singapore
E-mail: [email protected]
Received date: December 21, 2016; Accepted date: February 02, 2017; Published date: February 08, 2017
Citation: Jia JT, Shitalkumar S, Harikrishnan K (2017) Effective Illustration of Decommissioning of Left Ventricular Assist Device after Bridge-to- Recovery by Hybrid Minimally-Invasive Tactic: Anesthesia Substances. J Anesth Clin Res 8:702. doi:10.4172/2155-6148.1000702
Copyright: © 2017 Jia TY, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We report successful decommissioning of HeartWare left ventricular assist device (LVAD) (HVAD, HeartWare Inc., Framingham, MA) leaving the pump in situ by hybrid percutaneous approach. In this case, the indication for mechanical assist device separation was myocardial recovery, which occurred following 19 months of LVAD support. Anaesthetic goals include maintenance of sinus rhythm, avoidance of myocardial depression and increase in systemic vascular resistance (SVR), with optimal blood pressure control, normothermia, and judicious fluid management. Intraoperative assessment of suitability to wean using transesophageal echocardiography (TEE) and continuous cardiac output monitoring with pulmonary artery catheter must be expedient as no anticoagulation is given. This case report demonstrates the feasibility of separating a patient from a LVAD without the need for a major re-operative intervention.