Left ventricular assist device (LVAD) and anticoagulation therapy- An up-to-date review for the perioperative physician

Title : Left ventricular assist device (LVAD) and anticoagulation therapy- An up-to-date review for the perioperative physician

Abstract:

The management of anticoagulation therapy in patients with a LVAD undergoing non-cardiac surgery has been a subject of considerable apprehension and controversy in the literature.  Currently, the management of anticoagulation in emergent clinical settings are often made in a multidisciplinary approach including cardiac surgery, heart failure as well as the critical care physician.  This lecture will provide a brief review on the history of LVADs and will discuss the hemocompatibility related adverse events associated with LVADs.  I will further discuss the current recommendation on third generation LVAD anticoagulation as well as the controversy in the literature regarding these recommendations and potential changes in anticoagulation therapy in the near future.  I will also discuss anticoagulation management strategies in patients undergoing emergent non-cardiac surgery for the perioperative physician.

Audience Take Away Notes:

• Analyze and understand the current controversy on anticoagulation therapy in the third generation LVADs.
• Understanding the hemocompatibility adverse effects associated with LVADs
• Perioperative management of anticoagulation therapy in patients with an LVAD undergoing emergent non-cardiac surgery

Biography:

Dr. Christopher W. Tam, MD is a cardiac and critical care anesthesiologist practicing at Montefiore Medical Center.  He was previously at Weill Cornell Medical Center and joined Montefiore in 2022 as the program director for the upcoming Anesthesiology Critical Care Fellowship.  He attended medical school at the State University of New York at Downstate and graduated in 2010.  Subsequently, Dr. Tam completed residency at the State University of New York at Stony Brook in 2014 before completing Anesthesiology Critical Care Fellowship in 2015 and Cardiothoracic Anesthesiology Fellowship in 2016 at Weill Cornell Medical Center.  In addition to his interest in clinical education to residents and fellows, Dr. Tam is involved in clinical research involving transesophageal echocardiography, point of care ultrasound and postoperative cardiac surgery outcomes research utilizing database and have had published research articles in this area.