Dangerous surgical scavenger hunt: The complicated course of a patient with left ventricular assist device and end-stage renal disease undergoing reconstructive flap surgery

M. Freundt, A. Haneya, C. Schmid, S. Hirt

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with left ventricular assist devices (LVADs) who develop stage IV sacral pressure sores (SPS) have an increased procedural risk. We present the complications, including severe intra- and postoperative bleeding, diarrhea with metabolic acidosis, volume loss and acute on chronic renal failure, flap dehiscence and late LVAD outflow cannula thrombosis, in a 54-year-old male who underwent diverting ileostomy (DI) and subsequent fasciocutaneous flap (FCF) surgery for stage IV SPS while supported with an LVAD. Our experience suggests that, despite continuous heparinization, life-threatening thrombotic complications, such as device clotting, can occur. Therefore, the benefit of intervention has to outweigh the risk of bleeding, which should be managed with meticulous surgical technique and substitution of red blood cells rather than the reversal of heparinization or the substitution of clotting factors. Continuation of double anti-platelet therapy should also be considered.

Original languageEnglish (US)
Pages (from-to)469-471
Number of pages3
JournalPerfusion (United Kingdom)
Volume30
Issue number6
DOIs
StatePublished - Sep 19 2015

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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