Department of Anesthesiology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY.
Department of Anesthesiology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY.
J Cardiothorac Vasc Anesth. 2021 Oct;35(10):3035-3038. doi: 10.1053/j.jvca.2020.12.019. Epub 2020 Dec 17.
Increased survival with left ventricular assist devices (LVAD) has led to a large number of patients with LVADs presenting for noncardiac surgeries (NCS). With studies showing that a trained noncardiac anesthesiologist can safely manage these patients when they present for NCS, it is vital that all anesthesiologists understand the LVAD physiology and its implications in various surgeries. This is even more relevant during the current pandemic in which these complex cardiopulmonary interactions may be even more challenging in patients with coronavirus disease 2019 (COVID-19). The authors describe a case of a patient with COVID-19 with an LVAD who needed thoracoscopic decortication for recurrent complex pleural effusion and briefly discuss unique challenges presented and their management.
左心室辅助装置(LVAD)的生存率提高导致大量 LVAD 患者需要进行非心脏手术(NCS)。研究表明,经过培训的非心脏麻醉师在患者进行 NCS 时可以安全地进行管理,因此所有麻醉师了解 LVAD 生理学及其在各种手术中的影响至关重要。在当前的大流行期间,这些复杂的心肺相互作用在患有 2019 年冠状病毒病(COVID-19)的患者中可能更具挑战性,这一点更为重要。作者描述了一位 COVID-19 合并 LVAD 的患者需要进行胸腔镜去皮质术以治疗复发性复杂胸腔积液的病例,并简要讨论了所面临的独特挑战及其管理。