Indian Journal of Anaesthesia

CASE REPORT
Year
: 2013  |  Volume : 57  |  Issue : 1  |  Page : 56--61

Our experience with implantation of VentrAssist left ventricular assist device


Hiriyur Shivalingappa Jayanthkumar, Chinnamuthu Murugesan, John Rajkumar, Bandlapally Ramanjaneya Gupta Harish, Kanchi Muralidhar 
 Department of Anaesthesiology, Narayana Hrudayalaya Institute of Medical Sciences, Bommasandra Industrial Area, Anekal Taluk, Bangalore, Karnataka, India

Correspondence Address:
Hiriyur Shivalingappa Jayanthkumar
Department of Anaesthesiology, Narayana Hrudayalaya Institute of Medical Sciences, #258/A, Bommasandra Industrial Area, Anekal Taluk, Bangalore, Karnataka
India

Perioperative anaesthetic management of the VentrAssist TM left ventricular assist device (LVAD) is a challenge for anaesthesiologists because patients presenting for this operation have long-standing cardiac failure and often have associated hepatic and renal impairment, which may significantly alter the pharmacokinetics of administered drugs and render the patients coagulopathic. The VentrAssist is implanted by midline sternotomy. A brief period of cardiopulmonary bypass (CPB) for apical cannulation of left ventricle is needed. The centrifugal pump, which produces non-pulsatile, continuous flow, is positioned in the left sub-diaphragmatic pocket. This LVAD is preload dependent and afterload sensitive. Transoesophageal echocardiography is an essential tool to rule out contraindications and to ensure proper inflow cannula position, and following the implantation of LVAD, to ensure right ventricular (RV) function. The anaesthesiologist should be prepared to manage cardiac decompensation and acute desaturation before initiation of CPB, as well as RV failure and severe coagulopathic bleeding after CPB. Three patients had undergone implantation of VentrAssist in our hospital. This pump provides flow of 5 l/min depending on preload, afterload and pump speed. All the patients were discharged after an average of 30 days. There was no perioperative mortality.


How to cite this article:
Jayanthkumar HS, Murugesan C, Rajkumar J, Gupta Harish BR, Muralidhar K. Our experience with implantation of VentrAssist left ventricular assist device.Indian J Anaesth 2013;57:56-61


How to cite this URL:
Jayanthkumar HS, Murugesan C, Rajkumar J, Gupta Harish BR, Muralidhar K. Our experience with implantation of VentrAssist left ventricular assist device. Indian J Anaesth [serial online] 2013 [cited 2020 Oct 1 ];57:56-61
Available from: http://www.ijaweb.org/article.asp?issn=0019-5049;year=2013;volume=57;issue=1;spage=56;epage=61;aulast=Jayanthkumar;type=0