BRAZILIAN JOURNAL OF CARDIOVASCULAR SURGERY, cilt.39, sa.3, ss.1-5, 2024 (SCI-Expanded)
ABSTRACT
Introduction: Limited options in the end-stage treatment of heart failure have
led to increased use of left ventricular assist devices. For this reason, the rate
of non-cardiac surgeries in patients with left ventricular assist devices is also
increasing. Our study aims to analyze surgical rate, anesthesia management,
and results by reviewing our 11-year experience with patients who underwent
non-cardiac surgery receiving left ventricular assist devices support.
Methods: We retrospectively evaluated 57 patients who underwent non-cardiac
surgery and 67 non-cardiac surgical procedures among 274 patients who applied
between January 2011 and December 2022 and underwent left ventricular assist
devices implantation with end-stage heart failure.
Results: Fifty (74.6%) patients with left ventricular assist devices admitted to
the hospital for non-cardiac surgery were emergency interventions. The most
common reasons for admission were general surgery (52.2%), driveline wound
revision (22.3%), and neurological surgery (14.9%). This patient group has the
highest in-hospital mortality rate (12.8%) and the highest rate of neurological
surgery (8.7%). While 70% of the patients who underwent neurosurgery were
taken to surgery urgently, the International Normalized Ratio values of these
patients were between 3.5 and 4.5 at the time of admission to the emergency
department.
Conclusion: With a perioperative multidisciplinary approach, higher morbidity
and mortality risks can be reduced during emergencies and major surgical
procedures