Anesthetic considerations for LVAD implantation
Mark Heath, MD
Department of Anesthesiology
Columbia University
New York Presbyterian Hospital
email: mh22@columbia.edu
pre-op:
central line in addition to PA/Cordis, blood warmer attached.
Abx: levofloxaxin 500mg
fluconazole
solumedrol
Avoid vecuronium, use cis-atracurium
Use aprotinin
Pre cpb
check for ASD/PFO
check for AI
Preparing to separate from cpb:
6U PRBC
12U plts
6U ffp
Available drips:
milrinone
dobutamine
vasopressin
levophed
Consider NO
Post CPB -
CHECK for ASD/PFO - BEFORE PROTAMINE!!
check for AI
check for LV emptying
compare thermodilution cardiac output with LVAD flow
After protamine, send CBC and coags before giving products
CPMC active study protocols: