#43 – LVADs in non-cardiac surgery with Ben Levin, MD

Ben Levin, MD This podcast was the last episode I published on From the Head of the Bed and originally came out on July 4, 2020.  In August of that year, I launched Anesthesia Guidebook and this episode is being re-released on September 16, 2021.    In this episode, I have the privilege of speaking with Ben Levin, MD on the perioperative management of patients with left ventricular assist devices (LVADs) for non-cardiac surgery. This is your podcast if you’re looking for a refresher or quick overview of managing patients with LVADs as an anesthesia provider! We discuss how LVADs work, why people have them, the differences between LVADs as bridge to transplant or destination therapy and crucially, how to manage these patients perioperatively during non-cardiac surgery with special emphasis on monitoring and hemodynamic management. Dr Levin received his Master’s of Science in biomedicine and his medical degree from Tufts University Medical School. He completed his anesthesia residency at Maine Medical Center in Portland, Maine in 2020 and recently returned to MMC after completing a fellowship in critical care at Massachusetts General Hospital. His clinical areas of interest include cardiovascular surgery and critical care, echocardiography and mechanical circulatory support devices.  Dr Levin provided a PDF of a presentation on LVADs he gave as his senior project during his residency and you can find that below.  It’s got all the references, studies, graphs, management algorithms, chest xrays and device pictures you could want to make this info sink in. LVADs-with-Ben-Levin-PDFDownload References Rogers, J. G., Butler, J., Lansman, S. L., Gass, A., Portner, P. M., Pasque, M. K., … & INTrEPID Investigators. (2007). Chronic mechanical circulatory support for inotrope-dependent heart failure patients who are not transplant candidates: results of the INTrEPID Trial. Journal of the American College of Cardiology, 50(8), 741-747. Rose, E. A., Gelijns, A. C., Moskowitz, A. J., Heitjan, D. F., Stevenson, L. W., Dembitsky, W., … & Watson, J. T. (2001). Long-term use of a left ventricular assist device for end-stage heart failure. New England Journal of Medicine, 345(20), 1435-1443.