Trasplante cardíaco en pacientes portadores de asistencia ventricular izquierda de larga duración: «trucos y consejos»

Abstract

Performing heart transplantation in patients with long-term ventricular assist devices (LVADs) is both a surgical and medical management challenge. Given the lack of donors, heart transplants under these conditions are increasing, so it is necessary to plan the entire process starting from the implantation of the device, which will allow to foresee possible complications and their respective solutions, thus obtaining best results. We describe the guidelines to be taken into account in LVAD implantation (access, location and route of the outflow graft, driveline, closure), as well as in the planning and performance of the transplant, making a brief comment on two important aspects about the usual hemodynamic management in these cases. (C) 2022 Sociedad Espanola de Cirugla Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U.