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The Spectrum of General Surgery Interventions in Pediatric Patients with Ventricular Assist Devices

Kamel Fady; Buchholz, Holger; Dicken, Bryan; Conway, Jennifer
doi: 10.1097/MAT.0000000000000609
Pediatric Circulatory Support: PDF Only

Ventricular assist devices (VADs) have positively impacted the management of heart failure. However, they come with a range of complications. Although general surgical complications have been assessed in adults with VADs, there is no study to date that has assessed general surgery intervention in the pediatric population. Fifty-two patients who received VADs from 2005 to 2015 at the Stollery Children’s Hospital were assessed for general surgery intervention and anticoagulation status at the time of intervention. Eighteen patients (35%) had general surgery intervention; there were 21 nonemergency procedures and six emergency procedures performed. For nonemergency procedures, 89% of patients had anticoagulation held within 24 hours of surgery and 84% had anticoagulation resumed within 4 hours postoperatively. Antiplatelet therapy was not held perioperatively. In both emergency and nonemergency procedures, anticoagulation status was not a factor in the success of the procedure. This study shows that it is safe to have general surgery intervention on the same admission as a VAD implant provided an appropriate interdisciplinary healthcare team is involved with the perioperative management of the patient.

Submitted for consideration December 2016; accepted for publication in revised form May 2017.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Jennifer Conway, WMC 4C2, Division of Pediatric Cardiology, Stollery Children’s Hospital, 8440 112 St. NW, Edmonton, AB, T6G 2B7, Canada. Email: jennifer.conway2@albertahealthservices.ca.

Copyright © 2017 by the American Society for Artificial Internal Organs