Anesthetic management of the patient with a ventricular assist device

The use of long- and short-term mechanical circulatory support in the form of ventricular assist device (VAD) has increased over the last decade. Although cardiothoracic anesthesiologists care for these patients during device placement, increasingly higher numbers of general anesthesiologists are involved in the management of VAD patients during noncardiac surgery and procedures. An understanding of devices, their indications, and complications is essential to the anesthesiologists caring for these patients. We review the anesthetic considerations for the implantation of these devices and concerns when caring for patients with durable and short-term devices already in place.