Anesthesia at the Edge of Life: Mechanical Circulatory Support

Mechanical circulatory support devices are increasingly being used for patients presenting with heart failure. The primary goal of these devices is to maintain perfusion to all organs. Intra-aortic balloon pump and extracorporeal membrane oxygenators are temporary devices that are usually reserved for patients presenting with acute heart failure. A left ventricular assist device may be implanted either as a bridge to heart transplant or to cardiac recovery, or for destination therapy in refractory heart failure. Familiarization with these devices is key to patient management in the perioperative period, especially for patients presenting for noncardiac surgeries.