Ventricular Assist Devices

Left ventricular assist devices (LVADs) have found increasing use since their initial approval in 1994. They can be used as bridge therapy to heart transplantation or as destination therapy for patients in whom transplants are not possible. The increasing number of LVAD implants, combined with longer life expectancies, has resulted in growth in this patient population. This has also resulted in the development of additional complications, and these patients often present for noncardiac interventions. Anesthesiologists must be familiar with currently available devices, LVAD physiology, common perioperative complications, and effects of anesthesia on LVAD physiology when they manage these patients intraoperatively.