Anesthetic implications

A left ventricular assist device (LVAD) is intended for use as a temporary bridge to transplantation in patients with end-stage cardiac failure until a donor heart becomes available. This case report discusses the anesthetic management of a patient undergoing implantation of an LVAD. Tremendous advances have been made in cardiac transplantation; however, there is an acute donor shortage in the face of an increased need for donor hearts. These two factors have been the impetus for the development and testing of a mechanical assist device. A new U.S. Food and Drug Administration approved assist device, the Thermo-Cardiosystems, Inc. (Woburn, Massachusetts) implantable pneumatic LVAD is proving to be very successful as a bridge to transplantation. A case is presented of a 40-year-old male with debilitating cardiomyopathy in conjunction with mitral regurgitation, pulmonary hypertension, and mild tricuspid regurgitation. He had reached the point of multisystem organ failure which had left him incapacitated while awaiting cardiac transplantation.