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Left Ventricular Assist Device Backup for Conventional Surgery

Surgical revascularization plays a significant role in the management of patients with ischemic cardiomyopathy; however, fall patients have equivalent surgical risk, and in fact some are viewed as high-risk candidates due to severe systolic dysfunction or multiple medical comorbidities. The use of perioperative and intraoperative temporary mechanical circulatory support with a left ventricular assist device (LVAD) offers an option for potentially reducing surgical risk for these patients. This chapter highlights case examples from one institution in which temporary LVADs are utilized in order to optimize patients for conventional cardiac surgery including coronary artery bypass grafting (CABG). It briefly reviews the utility of preoperative viability assessment and proposes key factors for the identification of patients who may benefit from this novel strategy.