Anesthesia Management and Perioperative Outcome in Patients Receiving Left Ventricular Assisted Device Implantation
10.3969/j.issn.1000-3614.2025.10.003
- VernacularTitle:左心室辅助装置植入术的麻醉管理及围术期结局
- Author:
Jingfei GUO
1
;
Wenying KANG
;
Xianqiang WANG
;
Fujian DUAN
;
Jia SHI
;
Bingyang JI
;
Haibo CHEN
;
Xingtong ZHOU
;
Su YUAN
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 麻醉中心,北京 100037
- Publication Type:Journal Article
- Keywords:
left ventricular assisted device;
cardiac anesthesia;
blood conservation;
perioperative outcomes
- From:
Chinese Circulation Journal
2025;40(10):970-976
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:Recently,domestical developed left ventricular assist devices(LVAD)have been frequently introduced into clinical practice.This study aims to report the anesthesia protocol and perioperative outcomes in Chinese patients receiving LVAD implantation surgery.Methods:This retrospective analysis included patients who underwent LVAD implantation at our center from June 2017 to November 2024.During and after separation from cardiopulmonary bypass,we optimized right heart function through careful adjustments in heart rate,rhythm,preload,myocardial contractility,and afterload.Vasoactive agents were administered as needed,and mechanical ventilation parameters were optimized.We implemented blood conservation strategies and established strict transfusion criteria to minimize allogenic blood transfusions.Results:A total of 100 patients were included in the analysis,with 54.0%classified as Interagency Registry for Mechanically Assisted Circulatory Support(INTERMACS)I or II.Before leaving the operating room,the mean arterial pressure(MAP),mean pulmonary arterial pressure(mPAP),central venous pressure(CVP),lactic acid levels,and urinary output after cardiopulmonary bypass were recorded as(74±7)mmHg,(25±7)mmHg,(7±3)mmHg,(2.3±1.9)mmol/L,and(8.2±5.4)ml/(kg·h),respectively.The transfusion rates for red blood cells and fresh frozen plasma were 20.0%and 28.0%.The in-hospital mortality rate was 3.0%,with a low incidence of severe complications including right heart failure(12%).Left ventricular ejection fraction increased from(23.7±4.8)%preoperatively to(25.3±10.5)%prior to discharge.Conclusions:Patients who received LVAD at our center exhibited low rates of postoperative mortality and complications and significant improvement in left heart function before discharge.
