Perioperative Management of the Patient With a Left Ventricular Assist Device for Noncardiac Surgery

The pandemic of heart failure and the limited options for treatment of end-stage disease have resulted in an increase in the utilization of left ventricular assist devices (LVADs). Improvements in device technology and patient survival have led to an expanding population of patients requiring noncardiac surgery while on LVAD therapy, thus leading to a growing need for familiarity with the physiology of these patients. This review describes the functional mechanics of the most prevalent continuous-flow LVAD, the HeartMate II, and focuses on perioperative anesthetic concerns. Accepted for publication October 16, 2017. Funding: None. The author declares no conflicts of interest. Reprints will not be available from the author. Address correspondence to Mabel Chung, MD, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114. Address e-mail to mchung8@mgh.harvard.edu. © 2017 International Anesthesia Research Society

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