Mechanical circulatory support and its implications for anaesthesia and critical care.

Mechanical circulatory support is an increasingly important strategy for the treatment of a subset of patients with acute heart failure. Use of extracorporeal circuits with pumps and oxygenators to augment cardiac function can be immediately lifesaving, whereas implantable therapies can allow patients, with advanced heart disease, to resume near normal lives. Options for mechanical support are expanding, with long-term prognosis improving as devices become more sophisticated and complication rates fall. The perioperative management of such patients is reliant on complex specialist pathways and effective multidisciplinary decision-making. Critical care considerations for mechanical circulatory support are wide-ranging, and an understanding of the underlying physiology, device circuitry, anticoagulation, haemostasis, invasive monitoring and transoesophageal echocardiography is essential. [ABSTRACT FROM AUTHOR]