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Objective: To comprehensively assess relevant institutional variations in anesthesia and intensive care management during left ventricular assist device (LVAD) implantation., Design: The authors used a prospective data analysis., Setting: This was an online survey., Participants: Participants were from LVAD centers in Europe and the US., Interventions: After investigating initial interest, 91 of 202 European and 93 of 195 US centers received a link to the survey targeting institutional organization and experience, perioperative hemodynamic monitoring, medical management, and postoperative intensive care aspects., Measurements and Main Results: The survey was completed by 73 (36.1%) European and 60 (30.8%) US centers. Although most LVAD implantations were performed in university hospitals (>5 years of experience), significant differences were observed in the composition of the preoperative multidisciplinary team and provision of intraoperative care. No significant differences in monitoring or induction agents were observed. Propofol was used more often for maintenance in Europe (p < 0.001). The choice for inotropes changed significantly from preoperatively (more levosimendan in Europe) to intraoperatively (more use of epinephrine in both Europe and the US). The use of quantitative methods for defining right ventricular (RV) function was reported more often from European centers than from US centers (p < 0.05). Temporary mechanical circulatory support for the treatment of RV failure was more often used in Europe. Nitric oxide appeared to play a major role only intraoperatively. There were no significant differences in early postoperative complications reported from European versus US centers., Conclusions: Although the perioperative practice of care for patients undergoing LVAD implantation differs in several aspects between Europe and the US, there were no perceived differences in early postoperative complications., Competing Interests: Declaration of Competing Interest This research itself did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. J.M.B. received honoraria for lectures from Edwards Lifesciences. K.B. received funding from the Agency for Healthcare Research and a grant from the National Institutes of Health. O.B. received honoraria for lectures from Medtronic, Livanova, and Werfen. M.L.B. received research funding from the US Department of Defense. B.A.B. received consulting fees from CSL Behring. J.L.B. received an SCA/IARS mid-career research grant. E.D.A. received travel expenses from GE and Carmat. E.E.C.d.W. received honoraria for lectures and research grants from Abbott and Cytosorbents. D.A.E. received payment for expert testimony from Cornelius & Collins and Husch Blackwell. P.G. received consulting fees from Abbott and honoraria for lectures from Abbott and Eurosets. F.G. received honoraria for lectures from Abbott, Amomed, Edwards, Masimi, Orion, Orphan, and Teleflex. M.H. received honoraria for lectures from AOP Health, Medtronic, and Orion Pharma. L.M.J. received an educational grant from Abbott and participated in the DSMB of Carmat. L.M.K. received honoraria for grand round presentations and for a continuing medical education lecture and payment for an expert witness review from Shumaker Law firm. Z.N.K. has stock options from Edwards and Abbott. P.K. received research grants from Netzwerk Universitätsmedizin, APEPTICO, and BMBF; consulting fees from TEVA Ratiopharm, Amicus Ltd, and Senzyme; honoraria for lectures from TEVA Ratiopharm, Vifor, Sintetica, CSL Behring, and Senzyme; and payment from Ulsenheimer Friedrich Law Firm. D.J.K. owns exchange-traded funds with diversified holdings. M.M. received honoraria for lectures from Abbott Vascular, Boston Scientific, and Edwards Lifesciences. A.K.M. received consulting fees from Attgeno AB. N.M. received consulting fees from Edwards, Air Liquide, and Attgeno; honoraria for lectures from Edwards, Cytosorbents, and SOL; and travel expenses from Cytosorbents. M.A.M. received consulting fees from Octapharma and Hemosonics, honoraria for grand rounds of Mass General, and payment for expert testimony from Goodell Devries. V.K.M. participates in the Advisory Board of Tell Health and Fize Medical. J.P.O. had a consulting agreement with Third Pole Therapeutics and received a consulting fee from La Jolla Pharmaceutical. A.O. received consulting fees from Nordic Pharma, Isep, Baxter, Orion Pharma, VIFOR Pharma, and Medtronic and participated in the DSMB of the NaPar registry organized by Nordic Pharma. S.R. received honoraria for lectures from Abiomed, Edwards Lifesciences, Orion, and Nordic. H.R. received honoraria and travel expenses from Abbott. A.R. has stock or stock options from Clinical Gene Networks AB. P.S. received financial support for attending an expert German Intensive Care Society meeting. R.E.S. received travel expenses from Phillips. S.E.S. received an Abbott investigator grant and a consulting fee for manuscript writing with Lincoln Heart and Vascular Research Institute. M.S.S. received honoraria for lectures from Medtronic. K.S. received grants for research and royalties from Springer. A.S. received consulting fees from Baxter and honoraria for lectures from Amomed. M.t.H. had a speakers agreement with CSL Behring. V.v.D. received honoraria for lectures and travel expenses from Edwards Lifesciences and Orion Pharma. B.J.W. received a research grant from Haemonetics. M.S.C., M.D., N.M.G., and B.M. did not disclose their conflict of interests. None of the other authors have any disclosures to report., (Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.)