Journal of cardiac surgery
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As the number of heart failure patients supported with left ventricular assist devices (LVAD) increases, the frequency of elective, noncardiac surgery in this patient population will similarly rise. We retrospectively analyzed our LVAD patient database and identified six patients who underwent elective, noncardiac surgery while on LVAD support. These cases are discussed, with an emphasis on the anesthetic and perioperative considerations. These patients have an acceptable risk profile for elective surgery and should be treated similarly to their age-matched counterparts not on LVAD support.
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Case Reports
Aberrant left subclavian artery associated with a Kommerell's diverticulum and a left-sided aortic arch.
Kommerell's diverticulum is most commonly associated with either an aberrant left subclavian artery from a right-sided aortic arch or an aberrant right subclavian artery from a left-sided aortic arch. We describe an exceedingly rare case of an aberrant left subclavian artery arising from a Kommerell's diverticulum in a patient with a left-sided aortic arch, the "nonaberrant aberrant left subclavian artery."
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Postoperative delirium is a common medical complication following cardiac surgery. This paper will outline the treatment options for delirium with a focus on prophylactic use of risperidone before cardiac surgery.
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Blood transfusion carries benefits and risks. Adult cardiac surgery accounts for a significant proportion of all red blood cells transfusions. However, the identification of the patient, who will truly benefit from transfusions, is still controversial. This review provides an overview on allogenic blood transfusions in adult cardiac surgery.