Articles  |   October 2013
ACE Question
Article Information
Cardiovascular Anesthesia / Education / CPD / Articles
Articles   |   October 2013
ACE Question
ASA Monitor 10 2013, Vol.77, 52.
ASA Monitor 10 2013, Vol.77, 52.
A 26-year-old woman with postpartum cardiomyopathy presents for an open reduction and internal fixation of her fractured femur following a motor vehicle collision. She has a continuous-flow left ventricular assist device (LVAD) with a remaining battery life of three hours. You are called to the preoperative area because a blood pressure cannot be obtained noninvasively and the patient has no palpable pulse. The patient has a heart rate of 70/min on electrocardiogram. She is conversing with her family and is in no apparent distress. The MOST appropriate next step would be to:
Left ventricular assist devices (LVADs) are used as a bridge to heart transplantation or as an alternative to heart transplantation (destination therapy) in patients with end-stage heart failure. Certain LVAD systems, such as the HeartMate II, have nonpulsatile, continuous flow. Blood is removed from the left ventricle and returned via a pump to the ascending aorta, thereby decreasing left ventricular work. The LVAD pump is connected to an external controller via a percutaneous lead.
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