Safe Placement of Temporary Left Ventricular Assist Device Using Monitored Anesthesia Care and Regional Anesthesia in Patients With Cardiogenic Shock

John DePaolo, MD, PhD; Amit Iyengar, MD, MSE; Samuel Cohen, MD, MS; John J. Kelly, MD; Audrey E. Spelde, MD; Joyce Wald, DO; Emily J. Mackay, DO, MS; Michael Ibrahim, MBBS, PhD; Asad A. Usman, MD; Marisa Cevasco, MD, MPH

JACC: Case Reports (Nov 2023)

Safe Placement of Temporary Left Ventricular Assist Device Using Monitored Anesthesia Care and Regional Anesthesia in Patients With Cardiogenic Shock

John DePaolo, MD, PhD,
Amit Iyengar, MD, MSE,
Samuel Cohen, MD, MS,
John J. Kelly, MD,
Audrey E. Spelde, MD,
Joyce Wald, DO,
Emily J. Mackay, DO, MS,
Michael Ibrahim, MBBS, PhD,
Asad A. Usman, MD,
Marisa Cevasco, MD, MPH

Affiliations

John DePaolo, MD, PhD: Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Amit Iyengar, MD, MSE: Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Samuel Cohen, MD, MS: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
John J. Kelly, MD: Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Audrey E. Spelde, MD: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Joyce Wald, DO: Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Emily J. Mackay, DO, MS: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Michael Ibrahim, MBBS, PhD: Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Asad A. Usman, MD: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Marisa Cevasco, MD, MPH: Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Address for correspondence: Dr Marisa Cevasco, Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 1 Convention Ave, 2 City, Philadelphia, Pennsylvania 19104, USA.

Journal volume & issue: Vol. 26
p. 102067

Abstract

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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.)

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

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Abstract

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