BoardsBridgeLVAD for Non-Cardiac Surgery
Anesthetic management of durable continuous-flow LVAD patients presenting for elective or emergency non-cardiac procedures
Continuous-flow LVAD patients are preload-dependent and afterload-sensitive; maintain euvolemia, avoid hypertension and elevated PVR, and coordinate with the VAD team before induction.
If you forget
HEADLINE: Call VAD coordinator FIRST; bring backup controller and batteries to the OR.
Board trap
Key numbers
- MAP ≥60–65 mmHg or SBP ≥90 mmHg intraoperatively to reduce organ-injury risk (AHA/ACC 2024)
- PAPi <1.85 in HF patients undergoing LVAD implantation predicts postop RV failure (AHA 2023)
- PAPi ≤0.9 in AMI-CS is the concerning cutoff for RV failure (AHA 2023)
- Normal continuous-flow LVAD output ≈4–6 L/min; flow falls as MAP/SVR rises
- Class 1 (COR 1, C-EO) recommendation to coordinate elective NCS timing with VAD team (AHA/ACC 2024)
Uri Rozen, MD — Licensed Physician, Israel
Source guidelines: AHA ACC Perioperative Cardiovascular 2024 · AHA ACC Perioperative Cardiovascular 2024 · AHA ACC Perioperative Cardiovascular 2024 · AHA ACC Perioperative Cardiovascular 2024
Re-review cadence: 12 months from reviewed date.
Related on BoardsBridge
Card ID: lvad-non-cardiac · Path: aba.cardiac.arrhythmias-and-devices.lvad-non-cardiac