{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:52:49Z","timestamp":1783360369587,"version":"3.54.6"},"reference-count":22,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2025,1,30]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a rising number of patients with left ventricular assist devices (LVADs) undergoing non-cardiac procedures, both emergent and elective. Historically, anesthetic options for these patients have been limited to general anesthesia. Limited data exists for the use of neuraxial anesthesia in patients with LVADs despite its common use in orthopedic procedures for non-LVAD patients. Given the benefits of neuraxial anesthesia and the rising population of LVAD patients undergoing elective procedures, a better understanding of LVAD patients\u2019 candidacy for neuraxial anesthesia needs further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a patient with an LVAD who successfully underwent a total knee arthroplasty with neuraxial anesthesia at a tertiary academic center. Preoperative transthoracic echo demonstrated stable cardiac function and an ejection fraction of 10\u201315%\u2009with a HeartMate 3 LVAD. The primary anesthetic was a lumbar epidural that was slowly titrated to a surgical anesthetic level and an adductor canal peripheral nerve catheter was placed preoperatively for postoperative analgesia. The patient remained hemodynamically stable throughout the case, with a perfusionist monitoring the LVAD\u2019s function intraoperatively, and tolerated the anesthetic well. His postoperative course was uneventful.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with LVADs should be considered candidates for neuraxial anesthesia with appropriate preoperative planning and perioperative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2024-106253","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T12:55:14Z","timestamp":1739278514000},"page":"106-108","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Primary neuraxial anesthetic for elective total knee arthroplasty in patient with left ventricular assist device"],"prefix":"10.1136","volume":"51","author":[{"given":"Hanin","family":"Sheikh","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0707-311X","authenticated-orcid":false,"given":"Julia Isabella","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Kenneth Elliott","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W","family":"Patton","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"2026010506000665000_51.1.106.1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318286061d"},{"key":"2026010506000665000_51.1.106.2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev455"},{"key":"2026010506000665000_51.1.106.3","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000237267.75543.59"},{"key":"2026010506000665000_51.1.106.4","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000339"},{"key":"2026010506000665000_51.1.106.5","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182a1bf1c"},{"key":"2026010506000665000_51.1.106.6","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000055"},{"key":"2026010506000665000_51.1.106.7","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.113.000712","article-title":"Pregnancy complicated by valvular heart disease: an update","volume":"3","author":"Nanna","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"2026010506000665000_51.1.106.8","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ijoa.2020.06.001","article-title":"Anesthetic management of women with heart failure during pregnancy: a retrospective cohort study","volume":"44","author":"Jayasooriya","year":"2020","journal-title":"Int J Obstet Anesth"},{"key":"2026010506000665000_51.1.106.9","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.25118","article-title":"Trends, Perioperative Adverse Events, and Survival of Patients With Left Ventricular Assist Devices Undergoing Noncardiac Surgery","volume":"3","author":"Mentias","year":"2020","journal-title":"JAMA Netw 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Assist Device Implantation","volume":"62","author":"Taghavi","year":"2016","journal-title":"ASAIO J"},{"key":"2026010506000665000_51.1.106.15","doi-asserted-by":"crossref","DOI":"10.1016\/j.artd.2022.07.021","article-title":"Total Joint Arthroplasty in Patients With an Implanted Left Ventricular Assist Device","volume":"19","author":"Rosenberg","year":"2023","journal-title":"Arthroplast Today"},{"key":"2026010506000665000_51.1.106.16","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.CC.M.00286","article-title":"Total Hip Arthroplasty in a Patient with a Left Ventricular Assist Device: A Case Report","volume":"4","author":"Walton","year":"2014","journal-title":"JBJS Case Connect"},{"key":"2026010506000665000_51.1.106.17","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.arth.2012.06.010","article-title":"Total knee arthroplasty in patients with a left ventricular assist device","volume":"28","author":"Leonard","year":"2013","journal-title":"J Arthroplasty"},{"key":"2026010506000665000_51.1.106.18","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1053\/j.jvca.2020.10.012","article-title":"Elective Total Knee Replacement in a Patient With a Left Ventricular Assist Device-Navigating the Challenges With Spinal Anesthesia","volume":"35","author":"Fegley","year":"2021","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2026010506000665000_51.1.106.19","doi-asserted-by":"crossref","first-page":"351","DOI":"10.4103\/aca.ACA_239_17","article-title":"Facilitating noncardiac surgery for the patient with left ventricular assist device: A guide for the anesthesiologist","volume":"21","author":"Hwang","year":"2018","journal-title":"Ann Card Anaesth"},{"key":"2026010506000665000_51.1.106.20","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1213\/ANE.0000000000002669","article-title":"Perioperative Management of the Patient With a Left Ventricular Assist Device for Noncardiac 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