Comparison of Clinical Outcomes Between General Anesthesiologists and Cardiac Anesthesiologists in the Management of Left Ventricular Assist Device Patients in Noncardiac Surgeries and Procedures

To describe the authors’ experience and comparative results after introducing noncardiac fellowship-trained anesthesiologists to a service previously managed by fellowship-trained cardiac anesthesiologists caring for left ventricular assist device (LVAD) patients undergoing low-risk noncardiac procedures with anesthesia. A retrospective chart review. Single-site academic medical center in the United States. Anesthesia and intraoperative therapy. After initiating a brief training period for the noncardiac fellowship-trained anesthesiologists and blending the noncardiac anesthesiologists into the care of LVAD patients, the electronic medical records of 158 patients with an LVAD who underwent noncardiac procedures were reviewed. The cases were managed by either cardiac-trained anesthesiologists or noncardiac-trained anesthesiologists. Their performance was evaluated on the basis of technique and outcome. The parameters for technique were the use of intubation and mechanical ventilation, use of vasoactive medications, type of vasoactive medications administered, use of invasive monitoring, and type and amount of intravenous fluid administration. The outcomes examined included occurrence of intraoperative mean blood pressure