Anesthetic management of a patient with a femur fracture and ventricular assist device [Femur fraktürlü sol ventri·kül destek ci·hazli hastada anestezi· yöneti·mi·]

Mechanical cardiac support is an alternative to medical treatment in hemodynamic disturbances in patients with chronic congestive heart failure. Mechanical ventricular assist devices are used to provide support for impaired ventricular functions and they help to regulate end-organ functions by providing sufficient cardiac output. Ventricular assist devices are used to improve myocardial functions of patients with myocarditis, or they are used for patients who are candidates for cardiac transplantation whose myocardial functions are not expected to improve such as patients with end-stage cardiomyopathy. In this case, we present the anesthetic management of a 67-year-old patient with a left ventricular assist device who was a candidate for cardiac transplantation because of dilated cardiomyopathy and who underwent noncardiac surgery due to femur fracture. As the patient had a non-pulsatile ventricular assist device and bleeding diathesis, a radial artery catheter and a jugular central venous catheter were placed with ultrasound guidance. Besides, femoral nerve block and lateral femoral cutaneous nerve block were performed with ultrasound guidance for intraoperative and postoperative analgesia.