Current status of mechanical circulatory assistance.
Mechanical circulatory support has become an increasingly used management strategy for patients with both acute and chronic ventricular failure. This article briefly reviews the current state of mechanical circulatory support with a focus on indications, contraindications, and complications of currently available devices. Perioperative considerations for ventricular assist device implantation are discussed, including the decision-making process underlying the use of univentricular versus biventricular support, specific anesthetic considerations, and the role of transesophageal echocardiography where ventricular assist devices are concerned. The anesthetic considerations for the patient already supported by a ventricular assist device presenting for noncardiac surgery are also reviewed. The work concludes with a discussion of the rationale behind the next generation of continuous flow devices currently in human clinical trials.
Stone
Marc E
ME
Mount Sinai School of Medicine, New York, New York 10029-6574, USA. marc.stone@mountsinai.org
D000758:Anesthesia; D001810:Blood Volume / Q000502:physiology; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy; D006346:Heart Septum / Q000503:physiopathology; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000639:trends*; D006801:Humans; D008021:Life Support Systems; D008991:Monitoring, Physiologic; D010045:Outpatients; D011300:Preoperative Care; D016278:Ventricular Function, Right / Q000502:physiology