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Ophthalmic Surgery in Patients with Left Ventricular Assist Devices

The newer generation of left ventricular assist devices (LVADs) are commonly used as destination therapy; these devices have demonstrated improved outcomes and increased survival. Given the longer lifespan, it is not surprising that patients with LVADS are increasingly presenting with noncardiac, ch...

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Detalles Bibliográficos
Autores principales: Dumas, George A., Bryant, Ayesha S., Boyd, Gwendolyn L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446112/
https://www.ncbi.nlm.nih.gov/pubmed/31016058
http://dx.doi.org/10.1155/2019/5097597
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author Dumas, George A.
Bryant, Ayesha S.
Boyd, Gwendolyn L.
author_facet Dumas, George A.
Bryant, Ayesha S.
Boyd, Gwendolyn L.
author_sort Dumas, George A.
collection PubMed
description The newer generation of left ventricular assist devices (LVADs) are commonly used as destination therapy; these devices have demonstrated improved outcomes and increased survival. Given the longer lifespan, it is not surprising that patients with LVADS are increasingly presenting with noncardiac, chronic diseases and interventions for their treatment. This includes ophthalmic procedures in patients with LVAD. There is a paucity of literature about the experiences and outcomes in this cohort of patients presenting for ophthalmologic surgery. Here we present a case series consisting of 7 patients with LVAD that underwent 10 ophthalmic surgeries. No adverse events including intraoperative hemodynamic instability or respiratory compromise occurred. All patients had an on-time discharge with no 30-day recidivism. Most patients underwent a phacoemulsification with intraocular lens implantation and received a topical with intracameral anesthetic. We attribute these successful outcomes to a standardized clinical workflow consisting of careful preoperative screening, communication and presence of VAD coordinator, continuation of antithrombotics, monitoring based on presence of pulsatile flow, and a plan for rapid transfer if needed.
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spelling pubmed-64461122019-04-23 Ophthalmic Surgery in Patients with Left Ventricular Assist Devices Dumas, George A. Bryant, Ayesha S. Boyd, Gwendolyn L. Case Rep Ophthalmol Med Case Report The newer generation of left ventricular assist devices (LVADs) are commonly used as destination therapy; these devices have demonstrated improved outcomes and increased survival. Given the longer lifespan, it is not surprising that patients with LVADS are increasingly presenting with noncardiac, chronic diseases and interventions for their treatment. This includes ophthalmic procedures in patients with LVAD. There is a paucity of literature about the experiences and outcomes in this cohort of patients presenting for ophthalmologic surgery. Here we present a case series consisting of 7 patients with LVAD that underwent 10 ophthalmic surgeries. No adverse events including intraoperative hemodynamic instability or respiratory compromise occurred. All patients had an on-time discharge with no 30-day recidivism. Most patients underwent a phacoemulsification with intraocular lens implantation and received a topical with intracameral anesthetic. We attribute these successful outcomes to a standardized clinical workflow consisting of careful preoperative screening, communication and presence of VAD coordinator, continuation of antithrombotics, monitoring based on presence of pulsatile flow, and a plan for rapid transfer if needed. Hindawi 2019-03-20 /pmc/articles/PMC6446112/ /pubmed/31016058 http://dx.doi.org/10.1155/2019/5097597 Text en Copyright © 2019 George A. Dumas et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Dumas, George A.
Bryant, Ayesha S.
Boyd, Gwendolyn L.
Ophthalmic Surgery in Patients with Left Ventricular Assist Devices
title Ophthalmic Surgery in Patients with Left Ventricular Assist Devices
title_full Ophthalmic Surgery in Patients with Left Ventricular Assist Devices
title_fullStr Ophthalmic Surgery in Patients with Left Ventricular Assist Devices
title_full_unstemmed Ophthalmic Surgery in Patients with Left Ventricular Assist Devices
title_short Ophthalmic Surgery in Patients with Left Ventricular Assist Devices
title_sort ophthalmic surgery in patients with left ventricular assist devices
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446112/
https://www.ncbi.nlm.nih.gov/pubmed/31016058
http://dx.doi.org/10.1155/2019/5097597
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