Management of the in situ HeartMate II left ventricular assist device during non-transplant, non-exchange cardiac reoperations

Leora B. Balsam, Alex Reyentovich, Andre Y. Son, Abelardo DeAnda

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Cardiac surgery with cardiopulmonary bypass may be necessary in patients with pre-existing, continuous-flow, left ventricular assist devices. Heart transplantation or exchange of a malfunctioning left ventricular assist device are the most common scenarios. However, reoperation may also be needed for acquired valvular disease or device malposition. In these cases, operative strategies that enable safe conduct of cardiopulmonary bypass and, if needed, cardioplegic arrest while the left ventricular assist device remains in situ, are essential. Such strategies would avoid unnecessary replacement of working components of the left ventricular assist device and, importantly, avoid damage to them during the period of cardiopulmonary bypass. Adequate anticoagulation, avoidance of regurgitant flow into the device, prevention of blood stagnation in the hardware and careful deairing after periods of pump stoppage are key principles. We present a stepwise algorithm for the management of the HeartMate II device during such cases.

Original languageEnglish (US)
Pages (from-to)465-470
Number of pages6
JournalPerfusion
Volume31
Issue number6
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Fingerprint

Left ventricular assist devices
Heart-Assist Devices
Reoperation
Cardiopulmonary Bypass
stagnation
management
Equipment and Supplies
surgery
hardware
damages
scenario
Disease
Heart Transplantation
Surgery
Thoracic Surgery
Blood
Pumps
Hardware

Keywords

  • cardiopulmonary bypass
  • left ventricular assist device
  • mechanical circulatory support
  • reoperation

ASJC Scopus subject areas

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Management of the in situ HeartMate II left ventricular assist device during non-transplant, non-exchange cardiac reoperations. / Balsam, Leora B.; Reyentovich, Alex; Son, Andre Y.; DeAnda, Abelardo.

In: Perfusion, Vol. 31, No. 6, 01.09.2016, p. 465-470.

Research output: Contribution to journalArticle

@article{32497c15c6724fb7947644015347bb50,
title = "Management of the in situ HeartMate II left ventricular assist device during non-transplant, non-exchange cardiac reoperations",
abstract = "Cardiac surgery with cardiopulmonary bypass may be necessary in patients with pre-existing, continuous-flow, left ventricular assist devices. Heart transplantation or exchange of a malfunctioning left ventricular assist device are the most common scenarios. However, reoperation may also be needed for acquired valvular disease or device malposition. In these cases, operative strategies that enable safe conduct of cardiopulmonary bypass and, if needed, cardioplegic arrest while the left ventricular assist device remains in situ, are essential. Such strategies would avoid unnecessary replacement of working components of the left ventricular assist device and, importantly, avoid damage to them during the period of cardiopulmonary bypass. Adequate anticoagulation, avoidance of regurgitant flow into the device, prevention of blood stagnation in the hardware and careful deairing after periods of pump stoppage are key principles. We present a stepwise algorithm for the management of the HeartMate II device during such cases.",
keywords = "cardiopulmonary bypass, left ventricular assist device, mechanical circulatory support, reoperation",
author = "Balsam, {Leora B.} and Alex Reyentovich and Son, {Andre Y.} and Abelardo DeAnda",
year = "2016",
month = "9",
day = "1",
doi = "10.1177/0267659115624005",
language = "English (US)",
volume = "31",
pages = "465--470",
journal = "Perfusion (United Kingdom)",
issn = "0267-6591",
publisher = "SAGE Publications Ltd",
number = "6",

}

TY - JOUR

T1 - Management of the in situ HeartMate II left ventricular assist device during non-transplant, non-exchange cardiac reoperations

AU - Balsam, Leora B.

AU - Reyentovich, Alex

AU - Son, Andre Y.

AU - DeAnda, Abelardo

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Cardiac surgery with cardiopulmonary bypass may be necessary in patients with pre-existing, continuous-flow, left ventricular assist devices. Heart transplantation or exchange of a malfunctioning left ventricular assist device are the most common scenarios. However, reoperation may also be needed for acquired valvular disease or device malposition. In these cases, operative strategies that enable safe conduct of cardiopulmonary bypass and, if needed, cardioplegic arrest while the left ventricular assist device remains in situ, are essential. Such strategies would avoid unnecessary replacement of working components of the left ventricular assist device and, importantly, avoid damage to them during the period of cardiopulmonary bypass. Adequate anticoagulation, avoidance of regurgitant flow into the device, prevention of blood stagnation in the hardware and careful deairing after periods of pump stoppage are key principles. We present a stepwise algorithm for the management of the HeartMate II device during such cases.

AB - Cardiac surgery with cardiopulmonary bypass may be necessary in patients with pre-existing, continuous-flow, left ventricular assist devices. Heart transplantation or exchange of a malfunctioning left ventricular assist device are the most common scenarios. However, reoperation may also be needed for acquired valvular disease or device malposition. In these cases, operative strategies that enable safe conduct of cardiopulmonary bypass and, if needed, cardioplegic arrest while the left ventricular assist device remains in situ, are essential. Such strategies would avoid unnecessary replacement of working components of the left ventricular assist device and, importantly, avoid damage to them during the period of cardiopulmonary bypass. Adequate anticoagulation, avoidance of regurgitant flow into the device, prevention of blood stagnation in the hardware and careful deairing after periods of pump stoppage are key principles. We present a stepwise algorithm for the management of the HeartMate II device during such cases.

KW - cardiopulmonary bypass

KW - left ventricular assist device

KW - mechanical circulatory support

KW - reoperation

UR - http://www.scopus.com/inward/record.url?scp=84984904190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84984904190&partnerID=8YFLogxK

U2 - 10.1177/0267659115624005

DO - 10.1177/0267659115624005

M3 - Article

C2 - 26701904

AN - SCOPUS:84984904190

VL - 31

SP - 465

EP - 470

JO - Perfusion (United Kingdom)

JF - Perfusion (United Kingdom)

SN - 0267-6591

IS - 6

ER -