Successful Delivery in a Patient With Left Ventricular Assist Device and Unplanned Pregnancy

Makdisi, George; Jan, M.Y.; Dungy-Poythress, Lauren; Wang, I-Wen; Caccamo, Marco

doi:10.1016/j.athoracsur.2017.01.071

Cited by 22 publications

(17 citation statements)

References 5 publications

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“…Makdisi et al reported a 36‐year‐old patient who had a LVAD placed after acute decompensated heart failure due to nonischemic cardiomyopathy 7 . Approximately 9 months later, she presented pregnant at 20 to 21 weeks gestation with an ejection fraction of 25%.…”

Section: Discussionmentioning

confidence: 99%

“…Pregnancy has historically been considered contraindicated in patients requiring VAD support, given the increased risks to both mother and fetus as a result of the significant hemodynamic changes observed during pregnancy, difficulty with achieving adequate anticoagulation while balancing teratogenic risks to the fetus, and the physical stress surrounding delivery. To our knowledge, only three pregnancies in women with VAD have been completed 5–7 . In this report, we describe a successful pregnancy in a patient supported by LVAD.…”

Section: Introductionmentioning

confidence: 95%

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Left ventricular assist device in pregnancy: Case report and review of the literature

Malik

Winchester

Gorman

et al. 2021

J of Obstet and Gynaecol

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Left ventricular assist devices have emerged as a safe and effective therapy for end‐stage heart failure patients. However, little is known about the safety of these devices during pregnancy. We describe a 23‐year‐old woman who received a left ventricular device for nonischemic cardiomyopathy of uncertain origin. She became pregnant approximately 1 year later. With close monitoring of her hemodynamic parameters, she was able to achieve a gestational age of 34 weeks, at which time she delivered a healthy male infant by cesarean delivery. Pregnancies in women with left ventricular assist devices may be successful, but remain medically challenging and complex pregnancies. Close multidisciplinary involvement and frequent assessment of device parameters during pregnancy is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Left ventricular assist device in pregnancy: Case report and review of the literature

Malik

Winchester

Gorman

et al. 2021

J of Obstet and Gynaecol

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“…Short- or long-term MCS may rescue patients with peripartum cardiomyopathy [128]. Successful delivery in a patient with LT-MCS has been described [129].…”

Section: Management Of Non-cardiac Comorbiditiesmentioning

confidence: 99%

2019 EACTS Expert Consensus on long-term mechanical circulatory support

Potapov

Antonides

Crespo-Leiro

et al. 2019

European Journal of Cardio-Thoracic Surgery

284

446

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Long-term mechanical circulatory support (LT-MCS) is an important treatment modality for patients with severe heart failure. Different devices are available, and many—sometimes contradictory—observations regarding patient selection, surgical techniques, perioperative management and follow-up have been published. With the growing expertise in this field, the European Association for Cardio-Thoracic Surgery (EACTS) recognized a need for a structured multidisciplinary consensus about the approach to patients with LT-MCS. However, the evidence published so far is insufficient to allow for generation of meaningful guidelines complying with EACTS requirements. Instead, the EACTS presents an expert opinion in the LT-MCS field. This expert opinion addresses patient evaluation and preoperative optimization as well as management of cardiac and non-cardiac comorbidities. Further, extensive operative implantation techniques are summarized and evaluated by leading experts, depending on both patient characteristics and device selection. The faculty recognized that postoperative management is multidisciplinary and includes aspects of intensive care unit stay, rehabilitation, ambulatory care, myocardial recovery and end-of-life care and mirrored this fact in this paper. Additionally, the opinions of experts on diagnosis and management of adverse events including bleeding, cerebrovascular accidents and device malfunction are presented. In this expert consensus, the evidence for the complete management from patient selection to end-of-life care is carefully reviewed with the aim of guiding clinicians in optimizing management of patients considered for or supported by an LT-MCS device.

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“…Дисфункция печени влияет на уровень циркулирующих маркеров коагуляции до вмешательства и на потребность в препаратах крови после вмешательства. Кратковременные или долговременные вспомогательные миокардиальные устройства могут спасти пациентов с перипортальной кардиомиопатией [27].…”

Section: отбор кандидатов для имплантации удмцпмunclassified

Supporting Devices in the Treatment of Chronic Heart Failure in Elderly and Old Patients

et al. 2020

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Chronic heart failure (CHF) is a widespread disease associated with high rates of disability and mortality, as well as a decrease in the quality of life. Moreover, the vast majority of patients are elderly and senile. Modern surgical methods of treating heart failure are able to increase the duration and quality of life of such patients, however, the need far exceeds the volume of this care, and some highly effective methods common in Western countries are still not used in Russian clinical practice. Elderly age is a risk factor for the development of senile asthenia (frailty) and concomitant pathology. Large abdominal surgery is often contraindicated for patients with signs of senile asthenia, and the method of choice in patients with severe heart failure is the implantation of devices for long-term mechanical circulatory support (LT-MCS). After implantation of LT-MCS, a regression of signs of senile asthenia may be observed. The topic of an integrated approach to non-drug treatment of heart failure in elderly and senile patients in Russia has not been studied enough. In particular, the implantation of LT-MCS is not used in Russian clinical practice, while in many Western countries for many years it has been the main and most effective treatment for severe heart failure. Systematization of the available up-to-date information on this topic could help increase the duration and quality of life of patients with severe heart failure.

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Successful Delivery in a Patient With Left Ventricular Assist Device and Unplanned Pregnancy

Cited by 22 publications

References 5 publications

Left ventricular assist device in pregnancy: Case report and review of the literature

Left ventricular assist device in pregnancy: Case report and review of the literature

2019 EACTS Expert Consensus on long-term mechanical circulatory support

Supporting Devices in the Treatment of Chronic Heart Failure in Elderly and Old Patients

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