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. 2021 Sep;37(5):514-520.
doi: 10.1007/s12055-021-01192-3. Epub 2021 May 27.

Vascular procedures in patients with left ventricular assist devices: single-center experience

Saad Rustum #  1 , Julia Neuser #  1 , Jan Dieter Schmitto  1 , Thomas Aper  1 , Jasmin Sarah Hanke  1 , Axel Haverich  1 , Mathias Wilhelmi  1
Affiliations

Vascular procedures in patients with left ventricular assist devices: single-center experience

Saad Rustum et al. Indian J Thorac Cardiovasc Surg. 2021 Sep.

Abstract

Objective: A growing number of patients suffering from heart failure is living with a left ventricular assist device (LVAD) and is in the need for non-cardiac surgery. Vascular procedures due to ischemia, bleeding, or other device-related complications may be required and pose a challenge to the caregivers in terms of monitoring and management of these patients. Therefore, we reviewed our experience with LVAD patients undergoing vascular surgery.

Methods: From January 2010 until March 2017, a total of 54 vascular procedures were performed on 41 LVAD patients at our institution. Patient records were reviewed retrospectively in terms of incidence of LVAD-related complications, including thrombosis, stroke, bleeding, wound healing, and survival associated with vascular surgery. The type of surgery was recorded, as well as various clinical demographic variables.

Results: Vascular procedures were performed in 35 men (85.4%) and 6 women (14.6%) with LVADs. There were no perioperative strokes, device thromboses, or device malfunctions. Thirty-day mortality overall was 26.8% (eleven patients), with most patients dying within 30 days after LVAD implantation due to multi-organ failure. In 25 procedures (46.3%), a blood transfusion was necessary.

Conclusion: Patients on LVAD support are a complex cohort with a high risk for perioperative complications. In a setting where device function and anticoagulation are monitored closely, vascular surgery in these patients is feasible with an acceptable perioperative risk.

Keywords: Bleeding; LVAD; Thrombosis; Vascular surgery.

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Conflict of interest statement

Conflict of interestThe authors declare no competing interests.

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