Anesthetic management for implantation of total artificial heart device: Case series [Total yapay kalp cihazi implantasyonunda anestezik yaklaşim: Olgu serisi]

Abstract

The treatment of end-stage heart failure is heart transplant; however the majority of patients die due to deficiency of organ donation. Total artificial heart implantation made for the purpose of extending the life span and bridging to transplantation in patients with end-stage heart failure is a good option. We present our initial experiences in the anesthetic management of total artificial heart implantation cases performed in our institution. Five out of seven patients (46.8±8.4 years) were taken to surgery with inotropic support. Four patients were diagnosed as dilated cardiomyopathy. Three patients were subject to cardiac arrest during the preoperative period and mechanical ventilation was applied for one of these patients. Intraoperative ketamine, midazolam, fentanyl, rocuronium were used in doses of 192±89 mg, 8±3.5 mg, 335±157 µg and 192±43 mg, respectively. Fresh donor blood, fresh frozen plasma, thrombocyte and erythrocyte suspension requirements were 2.1±1.6 unit, 2± 1.8 unit, 0.43±0.5 unit and 0.6± 0.9 unit, respectively. At least one complication developed in all of the patients; four patients who had sepsis and renal failure died and; 3 patients who were not subject to this complication were discharged from the hospital. Total artificial heart implantation made for the purpose of bridging to transplantation for end-stage heart failure patients is a valuable option and its anaesthetic management is challenging. It is important that anesthesiologists have knowledge about the implanted device and the surgical procedure. © 2016 Nobelmedicus. All rights reserved