Placement of Temporary Left Ventricular Assist Device Using Monitored Anesthesia Care and Regional Anesthesia

John DePaolo; Amit Iyengar; Samuel Cohen; John J Kelly; Audrey E Spelde; Joyce Wald; Emily J Mackay; Michael Ibrahim; Asad A Usman; Marisa Cevasco

doi:10.1016/j.jaccas.2023.102067

Placement of Temporary Left Ventricular Assist Device Using Monitored Anesthesia Care and Regional Anesthesia

JACC Case Rep. 2023 Oct 7:26:102067. doi: 10.1016/j.jaccas.2023.102067. eCollection 2023 Nov 15.

Authors

Affiliations

¹ Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
² Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

Patients with advanced cardiogenic shock requiring mechanical circulatory support are uniquely susceptible to clinical deterioration. Limiting physiologic perturbations via avoidance of general anesthesia and endotracheal intubation by awake Impella 5.5 placement is safe and may represent a novel strategy in mechanical circulatory support initiation among patients in cardiogenic shock. (Level of Difficulty: Intermediate.).

Keywords: Impella 5.5; cardiogenic shock; mechanical circulatory support; monitored anesthesia care; regional anesthesia; temporary LVAD.

Publication types

Case Reports