医学
高碳酸血症
气腹
心室辅助装置
袖状胃切除术
外科
心力衰竭
心脏移植
心脏病学
腹腔镜检查
内科学
减肥
肥胖
低氧血症
胃分流术
作者
Rishi Kumar,Sarah Ellis,Ismael A. Salas de Armas,Manish Kumar Patel,Mehmet H. Akay,Kulvinder S. Bajwa,Yafen Liang,Igor D. Gregorič
出处
期刊:A&A practice
[Ovid Technologies (Wolters Kluwer)]
日期:2021-11-01
卷期号:15 (11): e01545-e01545
被引量:2
标识
DOI:10.1213/xaa.0000000000001545
摘要
The increasing coincidence of obesity with heart failure may preclude eligibility for orthotopic heart transplantation, requiring continuous-flow left ventricular assist devices (LVADs) as destination therapy. This report describes intraoperative considerations for patients who underwent LVAD implantation with concurrent laparoscopic sleeve gastrectomy (LSG) to promote weight loss. In particular, right ventricular dysfunction associated with acute left ventricular unloading may be compounded by pneumoperitoneum for LSG due to the difficulty in ventilating patients with obesity, hypercarbia-mediated increase in pulmonary vascular resistance, and variable cardiac loading conditions. We identify specific anesthetic challenges and discuss methods of monitoring and management.
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