Fegley MW, Gupta RG, Elkassabany N, Augoustides JG, Werlhof H, Gutsche JT, Kornfield ZN, Patel N, Sanders J, Fernando RJ, and Morris BN. Elective Total Knee Replacement in a Patient With a Left Ventricular Assist Device-Navigating the Challenges With Spinal Anesthesia. J Cardiothorac Vasc Anesth 2021; 35(2):662-669.
Journal of cardiothoracic and vascular anesthesia
Elective joint surgery in a patient with a left ventricular assist device (LVAD) may become increasingly common as these devices become entrenched in the management of patients with heart failure. Furthermore, regional techniques may be reasonable anesthetic options in this challenging population. This case conference discusses a spinal anesthetic for an elderly female with an LVAD who presented for an elective left total knee arthroplasty. The expert case commentaries that follow the case discussion further explore the anesthetic issues in light of the existing literature.