Perioperative Management: HeartMate 3 Left Ventricular Assist Devices in Non-Cardiac Surgery.

Area of Science:

• Cardiovascular Surgery
• Anesthesiology
• Biomedical Engineering

Background:

• The HeartMate 3 (HM3) is the most utilized left ventricular assist device globally.
• Technological advancements allow HM3 use for bridge-to-transplant and destination therapy.
• HM3 features magnetic levitation, wider flow pathways, and artificial pulse technology.

Purpose of the Study:

• To review the function, physiological implications, and perioperative complications of the HM3 device.
• To provide guidance for anesthesiologists managing patients with HM3 support.
• To emphasize the importance of understanding HM3 for safe anesthetic care.

Main Methods:

• Narrative review of the HM3 left ventricular assist device.
• Exploration of physical principles, technical parameters, and monitoring.
• Discussion of perioperative management strategies and emergency care.

Main Results:

• HM3 demonstrates improved hemocompatibility, reducing thrombosis, stroke, and bleeding.
• The device offers enhanced durability and fewer complications compared to predecessors.
• Anesthesiologists will increasingly encounter HM3 patients in various surgical contexts.

Conclusions:

• A thorough understanding of HM3 is crucial for safe anesthetic management.
• Multidisciplinary coordination and specific anesthetic approaches are vital.
• All anesthesiologists, especially in mechanical circulatory support centers, must be proficient with the HM3 system.