Journal article
Stroke and Left Ventricular Assist Device (LVAD)
Open Journal of Anesthesiology (Irvine, CA), Vol.3(1), pp.51-56
2013
DOI: 10.4236/ojanes.2013.31014
Abstract
Treatment of ischemic stroke for a patient on left ventricular assist device (LVAD) by neurointerventional means is rare and many anesthesia providers are unfamiliar with both LVAD and neurointerventional protocols. Examples of this include: 1) filling for continuous-flow LVAD depend on preload and the flow is inversely related to afterload; as mean arterial pressure (MAP) increases above 80 to90 mmHg, flow decreases; 2) there may be no palpable pulse in patients with continuous flow LVADs; 3) pulse oximetry may not work when pump flow is high and native myocardial function is minimal; 4) increasing MAP above80 mmHg potentially will maintain ischemic brain tissue—the penumbra—until flow is restored. This latter example creates a paradoxical management goal: increasing the mean arterial pressure (MAP) above80 mmHg while maintaining ischemic brain tissue, may decrease flow to the LVAD. Finally, there is controversy regarding which type of anesthesia is most efficacious for neuro interventional procedures. We describe three patients on LVAD suffering ischemic stroke requiring anesthesia for embolectomy and angioplasty during neruointeventioal radiology procedures.
Details
- Title: Subtitle
- Stroke and Left Ventricular Assist Device (LVAD)
- Creators
- Robert P. FromDavid HasanMichael T. FroehlerJennifer L. Goerbig-Campbell
- Resource Type
- Journal article
- Publication Details
- Open Journal of Anesthesiology (Irvine, CA), Vol.3(1), pp.51-56
- DOI
- 10.4236/ojanes.2013.31014
- ISSN
- 2164-5531
- eISSN
- 2164-5558
- Language
- English
- Date published
- 2013
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Anesthesia
- Record Identifier
- 9984418932202771
Metrics
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