Management of left ventricular assist devices after surgery: bridge, destination, and recovery

PURPOSE OF REVIEW: As the use and understanding of mechanical circulatory support (MCS) increases, the management of these devices has become more conventional. The purpose of this review is to discuss the perioperative and long-term management of MCS patients. RECENT FINDINGS: With the advent of axial flow pumps, both perioperative and long-term management are more standardized. The issues of nutrition, physical therapy, drive line care, and readiness to transition to home are becoming more mainstream and are readily accepted into the community. However, many factors remain that are not well defined in dealing with anticoagulation, weaning of MCS, achieving optimal device settings, and end-of-life care. SUMMARY: Care for the MCS patient provided in a multidisciplinary team approach is imperative to allow for a seamless transition from the hospital and into the community and successful long-term outcomes.