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Pregnancy with a Left Ventricular Assist Device: A Narrative Review

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Date 2025 Jan 24
PMID 39851146
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Abstract

This narrative review discusses the various challenges associated with the presence of a left ventricular assist device (LVAD) during pregnancy. Given the hemodynamic and coagulation changes associated with pregnancy, the presence of an LVAD adds a layer of complexity with respect to optimal management. This review will discuss the anesthetic considerations when dealing with this subset of patients who may have other comorbidities alongside their advanced heart failure. Additionally, this paper aims to review successful pregnancies with an LVAD placement focusing on the mode of delivery and hemodynamic management risk.

References
1.
Meyer A, Malehsa D, Bara C, Budde U, Slaughter M, Haverich A . Acquired von Willebrand syndrome in patients with an axial flow left ventricular assist device. Circ Heart Fail. 2010; 3(6):675-81. DOI: 10.1161/CIRCHEARTFAILURE.109.877597. View

2.
Hytten F . Blood volume changes in normal pregnancy. Clin Haematol. 1985; 14(3):601-12. View

3.
Yeomans E, Gilstrap 3rd L . Physiologic changes in pregnancy and their impact on critical care. Crit Care Med. 2005; 33(10 Suppl):S256-8. DOI: 10.1097/01.ccm.0000183540.69405.90. View

4.
Berardi C, Bravo C, Li S, Khorsandi M, Keenan J, Auld J . The History of Durable Left Ventricular Assist Devices and Comparison of Outcomes: HeartWare, HeartMate II, HeartMate 3, and the Future of Mechanical Circulatory Support. J Clin Med. 2022; 11(7). PMC: 9000165. DOI: 10.3390/jcm11072022. View

5.
Duhl A, Paidas M, Ural S, Branch W, Casele H, Cox-Gill J . Antithrombotic therapy and pregnancy: consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes. Am J Obstet Gynecol. 2007; 197(5):457.e1-21. DOI: 10.1016/j.ajog.2007.04.022. View