Freundt, M. and Haneya, A. and Schmid, C. and Hirt, S. (2015) Dangerous surgical scavenger hunt: the complicated course of a patient with left ventricular assist device and end-stage renal disease undergoing reconstructive flap surgery. PERFUSION-UK, 30 (6). pp. 469-471. ISSN 0267-6591, 1477-111X
Full text not available from this repository. (Request a copy)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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NONCARDIAC SURGERY; RISK; left ventricular assist device; flap surgery; intra-abdominal surgery; end-stage renal failure; complication |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 Jun 2019 14:18 |
| Last Modified: | 13 Jun 2019 14:18 |
| URI: | https://pred.uni-regensburg.de/id/eprint/4956 |
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