orthopedic surgical procedures in patients supported with long-term implantable left ventricular assist devices

接受长期植入式左心室辅助装置治疗的患者的骨科手术

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Abstract

With advancements in Left Ventricular Assist Devices (LVAD) technology, patients supported by LVAD are pursuing non-cardiac surgeries at a higher rate. This study is the largest retrospective case series to date to examine orthopedic surgery outcomes in this patient population. # Case Presentation From January 1, 2012, to December 31, 2022, there were 40 patients with LVAD who underwent 47 orthopedic surgeries at a Level II Trauma Center. The type of orthopedic procedure, time since LVAD implantation, length of hospital stays, blood loss, need for transfusion, postoperative thromboembolic events, and discharge destination were evaluated. # Management and Outcomes Orthopedic surgery in LVAD patients appears to have longer lengths of hospital stay, greater need for blood transfusion, higher emergency department visits, higher readmission rates, and a greater need for rehabilitation assistance. # Conclusion Orthopaedic surgery in patients with LVAD appears riskier, however, it is possible and may be necessary, optimization and collaborative inter-disciplinary care is paramount to success.

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