Ventricular assist devices and non-cardiac surgery

Area of Science:

• Cardiology
• Anesthesiology
• Medical Devices

Background:

• The prevalence of heart failure is rising globally.
• Ventricular assist devices (VADs) have seen expanded use since FDA approval in 1994.
• Patients with VADs increasingly require non-cardiac surgical interventions.

Purpose of the Study:

• To provide an overview of perioperative considerations for patients with VADs undergoing non-cardiac surgery.
• To outline management strategies for anesthesiologists caring for these complex patients.
• To highlight the growing need for expertise in managing mechanically supported patients.

Main Methods:

• A Medline search was conducted using terms: "ventricular assist device," "Heartmate," and "HeartWare."
• Relevant literature was selected to address perioperative management and physiology.
• The review focuses on challenges faced by general anesthesiologists.

Main Results:

• Patients with VADs are more frequently presenting for non-cardiac surgeries.
• The growing population of mechanically supported patients presents unique anesthetic challenges.
• Effective management requires understanding VAD physiology and a multidisciplinary approach.

Conclusions:

• General anesthesiologists will encounter more patients with VADs, potentially outside specialized centers.
• A thorough understanding of VAD physiology is crucial for perioperative care.
• Multidisciplinary collaboration is essential for optimizing outcomes in this patient population.