# Noncardiac Surgery in Patients with Left Ventricular Assist Devices: A 11-Year Institutional Experience

## TL;DR

This paper examines non-cardiac surgeries in patients with heart support devices, highlighting risks and outcomes over 11 years.

## Contribution

The study provides insights into the management and outcomes of non-cardiac surgeries in patients with left ventricular assist devices.

## Key findings

- Most non-cardiac surgeries were emergency interventions with high mortality rates.
- General surgery was the most common reason for non-cardiac procedures.
- A multidisciplinary approach can reduce risks during major surgeries.

## Abstract

Limited options in the end-stage treatment of heart failure have led to
increased use of left ventricular assist devices. For this reason, the rate
of non-cardiac surgeries in patients with left ventricular assist devices is
also increasing. Our study aims to analyze surgical rate, anesthesia
management, and results by reviewing our 11-year experience with patients
who underwent non-cardiac surgery receiving left ventricular assist devices
support.

We retrospectively evaluated 57 patients who underwent non-cardiac surgery
and 67 non-cardiac surgical procedures among 274 patients who applied
between January 2011 and December 2022 and underwent left ventricular assist
devices implantation with end-stage heart failure.

Fifty (74.6%) patients with left ventricular assist devices admitted to the
hospital for non-cardiac surgery were emergency interventions. The most
common reasons for admission were general surgery (52.2%), driveline wound
revision (22.3%), and neurological surgery (14.9%). This patient group has
the highest in-hospital mortality rate (12.8%) and the highest rate of
neurological surgery (8.7%). While 70% of the patients who underwent
neurosurgery were taken to surgery urgently, the International Normalized
Ratio values of these patients were between 3.5 and 4.5 at the time of
admission to the emergency department.

With a perioperative multidisciplinary approach, higher morbidity and
mortality risks can be reduced during emergencies and major surgical
procedures.