CRITICAL CARE MANAGEMENT OF THE ACUTE POST-IMPLANT LVAD PATIENT: Management of Acute Post-Op LVAD Patients

Abstract Left ventricular assist devices (LVADs) improve survival and quality of life in refractory end-stage heart failure. However, the therapy itself is associated with some degree of morbidity and mortality, at highest risk during the first 30 days post-implantation. Management of the freshly implanted LVAD patient requires an in-depth understanding of the acute post-implant period and common critical care issues, including coagulopathy, hemodynamic lability, and metabolic derangements. This requires meticulous hemostatic control and a firm understanding of hemodynamic principles that focus on optimizing end-organ perfusion, right ventricular function, and measured LVAD titration. This contemporary practical guide to management of the acute post-implant LVAD patient includes a focused approach to troubleshooting common LVAD issues that may arise from the operating room to discharge from critical care.