ABSTRACT
This chapter identifies some of the more common problems encountered in a patient who is supported with a mechanical blood pump. Right ventricular failure is not truly a complication associated with mechanical circulatory support but can make management of the patient requiring left heart support very difficult. Postoperative bleeding is multifactorial in origin. A preoperative coagulopathy related to the use of sodium warfarin, heparin sodium, aspirin, dipyridamole or anti-inflammatory drugs may be compounded by hepatic dysfunction and its attendant clotting abnormalities related to systemic hypoperfusion in the cardiomyopathic patient. Patients who suffer a perioperative neurologic event usually do so as a result of intraoperative low systemic flow or perfusion pressure, dislodgement of a left ventricular thrombus or inadequate left ventricular assist device deairing. Patients who require mechanical circulatory support usually have preexisting end organ dysfunction. A postoperative infection, regardless of etiology, can be a devastating complication if the responsible organism seeds the Ventricular assist device.
