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Developments in ventricular assist devices (VADs) and the limited supply of donor hearts for transplantation have made the former an important method of treatment for patients with end-stage heart failure. This chapter presents the case of a patient who underwent two surgical procedures for subdural hematoma evacuation while on left VAD (LVAD) support. Anesthetic management and potential problems such as coagulation status and hemodynamic stability in patients with an LVAD are presented and discussed. The chapter presents a case study of a 72-year-old male who presented for an emergent subdural hematoma decompression. As the number of patients chronically supported with long-term implantable devices grows, general surgical problems that are commonly seen in other hospitalized patients are becoming more common and will eventually lead to an increase in the number of patients with LVADs coming in for noncardiac elective or emergency surgery.
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