Anesthetic Management for Non-Cardiac Surgery in the Patient with Left Ventricular Assistance Device.

With the growing number of patients for left ventricular assist device (LVAD) implantation and their improved survival, more patients with LVAD can present for various types of noncardiac surgery. Therefore, anesthesiologists need to understand the physiology and be prepared for the perioperative management of this unique patient population. This review addresses the perioperative considerations and intraoperative management for safe and successful noncardiac surgeries in patients with LVAD. It is essential to understand the basic physiology represented by 'preload dependency and afterload sensitivity' in these patients. The main considerations include preoperative multidisciplinary collaborative approach and preparation, perioperative care to optimize the intravascular volume and right ventricular function and maintaining the afterload within recommended ranges for optimal LVAD function.