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Case 73 - Anestheticmanagement for subdural hematoma evacuation in a patient with a left ventricular assist device

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

Developments in ventricular assist devices (VADs) and the limited supply of donor hearts for transplantation have made the former an important method of treatment for patients with end-stage heart failure. This chapter presents the case of a patient who underwent two surgical procedures for subdural hematoma evacuation while on left VAD (LVAD) support. Anesthetic management and potential problems such as coagulation status and hemodynamic stability in patients with an LVAD are presented and discussed. The chapter presents a case study of a 72-year-old male who presented for an emergent subdural hematoma decompression. As the number of patients chronically supported with long-term implantable devices grows, general surgical problems that are commonly seen in other hospitalized patients are becoming more common and will eventually lead to an increase in the number of patients with LVADs coming in for noncardiac elective or emergency surgery.
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Publisher: Cambridge University Press
Print publication year: 2011

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