Concomitant LVAD Implantation and Thoracic Surgery. Clinical Decision Making and Surgical Challenges Volume 2 - Issue 4

Massimo Maiani¹, Sandro Sponga¹, Anita Brondani², Vincenzo Tursi¹, Angelo Morelli¹, Andrea Lechiancole*¹, Daniela Piani¹, Mauro Driussi¹, Helena Ortis¹ and Ugolino Livi¹

• ¹Cardiothoracic Department, University Hospital of Udine, Italy
• ²Department of Anesthesia, University Hospital of Udine, Italy

Received: November 21, 2019;   Published: December 10, 2019

Corresponding author: Andrea Lechiancole, Cardiothoracic Department, University Hospital of Udine, P le SM della Misericordia 1533100 Udine, Italy

DOI: 10.32474/ACR.2019.02.000144

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Abstract

In the last years, left ventricular assist device (LVAD) indications have significantly broadened including candidates with multiple comorbidities even requiring combined surgical strategy. We present a case of a 56-year old patient affected by postischemic dilated cardiomyopathy in whom a lung nodule diagnosed during preoperative CT-scan could have contraindicated LVAD destination therapy. The patient underwent through a median sternotomy concomitant LVAD implantation on cardiopulmonary bypass followed by an atypical resection of the anterior part of the right lower lobe lung. A multidisciplinary, step-by-step approach to reduce the risk of right ventricular failure, bleeding and infections is presented.

Keywords: LVAD implantation; non-cardiac surgery; atypical lung resection

Abstract| Introduction| Systematic Review in Last 20 years| Conclusion| References|