Outcomes Following Noncardiac Surgery in Patients with Ventricular Assist Devices: A Single-Center Experience.

MedStar author(s):
Citation: American Surgeon. 83(8):842-846, 2017 Aug 01PMID: 28822388Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Surgery/Burn Services | Surgery/Trauma SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Heart-Assist Devices | *Surgical Procedures, Operative | Female | Humans | Male | Middle Aged | Postoperative Complications/ep [Epidemiology] | Retrospective Studies | Risk Factors | Treatment OutcomeYear: 2017Local holdings: Available online through MWHC library: 2005 - present, Available in print through MWHC library:1999-2007ISSN:
  • 0003-1348
Name of journal: The American surgeonAbstract: the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. We retrospectively reviewed records on patients who underwent NCS after VAD implantation between 2013 and 2015 at a single Joint Commission-accredited VAD institution. Data collection included demographics, ischemic cardiomyopathy or nonischemic cardiomyopathy, operative details, and perioperative anticoagulation management and outcomes. Seventy-two NCS were performed by general surgeons, thoracic surgeons, plastic surgeons, urologists, vascular surgeons, ENTs, and other services. Procedures were similarly varied, including video-assisted thoracoscopy with decortications or lung biopsy, tracheostomies, percutaneous endoscopic gastrostomies , exploratory laparotomies, and wound debridements and/or closures. The ten deaths in the study group were judged not to be directly related to NCS. Eleven cases had postoperative bleeding and two cases had postoperative thrombosis, including one pump thrombosis. Based on our results, VAD is not an absolute contraindication to NCS, and a variety of NCS procedures can safely be performed. Further study should focus on quantifying and mitigating the risk that VADs bring to NCS.All authors: Chervu NL, Johnson LS, Kettyle SM, Majure D, Rao AS, Sadi S, Sava JAFiscal year: FY2018Date added to catalog: 2017-09-21
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28822388 Available 28822388

Available online through MWHC library: 2005 - present, Available in print through MWHC library:1999-2007

the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. We retrospectively reviewed records on patients who underwent NCS after VAD implantation between 2013 and 2015 at a single Joint Commission-accredited VAD institution. Data collection included demographics, ischemic cardiomyopathy or nonischemic cardiomyopathy, operative details, and perioperative anticoagulation management and outcomes. Seventy-two NCS were performed by general surgeons, thoracic surgeons, plastic surgeons, urologists, vascular surgeons, ENTs, and other services. Procedures were similarly varied, including video-assisted thoracoscopy with decortications or lung biopsy, tracheostomies, percutaneous endoscopic gastrostomies , exploratory laparotomies, and wound debridements and/or closures. The ten deaths in the study group were judged not to be directly related to NCS. Eleven cases had postoperative bleeding and two cases had postoperative thrombosis, including one pump thrombosis. Based on our results, VAD is not an absolute contraindication to NCS, and a variety of NCS procedures can safely be performed. Further study should focus on quantifying and mitigating the risk that VADs bring to NCS.

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