A panel of Chinese specialists has published a new expert consensus establishing standardized guidance for the perioperative management of adults undergoing implantation of a left ventricular assist device, or LVAD. The document, released in the journal Anesthesiology and Perioperative Science, was developed to address the absence of standardized perioperative management protocols for LVAD implantation in China and to build on recently published national consensus documents covering preoperative and postoperative care.
The consensus was jointly developed by the Chinese Society of Cardiothoracic Anesthesiology, the National Center for Cardiovascular Diseases Expert Committee, and the Beijing Medical Association. Its development panel comprised 83 specialists drawn from 41 clinical centers, and the project was registered on the Practice guideline REgistration for transPAREncy (PREPARE) platform under registration number PREPARE-2025CN1348.
According to the methods described in the consensus, the panel used the Population, Intervention, Comparator, and Outcomes (PICO) framework together with the Delphi method to systematically review relevant international guidelines and peer-reviewed literature published through April 2026. After synthesizing the evidence, the specialists held multiple rounds of expert discussion and formal voting, ultimately producing 11 core recommendations. The certainty of the evidence and the strength of each recommendation were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
The recommendations are organized around three phases of perioperative care: preoperative assessment, intraoperative management, and postoperative recovery. In the preoperative phase, the guidance emphasizes assessment of right ventricular function, prediction of postoperative right heart failure, and evaluation of the indications for LVAD implantation in order to support appropriate patient selection. Right ventricular performance is a central concern in LVAD care, and the consensus places particular weight on identifying patients at risk of postoperative right heart failure before surgery begins.
For the intraoperative phase, the recommendations specify hemodynamic targets, strategies for optimizing right ventricular performance, and blood-conservation measures intended to minimize transfusion requirements. These elements are designed to give surgical and anesthesia teams a common framework for managing patients during the implantation procedure itself, when maintaining stable circulation and limiting blood loss are key priorities.
The postoperative recommendations address multimodal analgesia and enhanced recovery after surgery (ERAS) protocols adapted to individual patient characteristics and institutional resources. Rather than prescribing a single rigid pathway, the consensus frames these measures as adaptable to the circumstances of each patient and each hospital, reflecting the variation in resources that exists across clinical centers.
A distinctive feature of the document is its summary of clinically relevant differences in the design and management of durable LVADs developed domestically and internationally. The panel notes that the increasing clinical use of domestically developed LVADs in China creates a need for context-specific guidance, and the consensus is intended to support device-specific care for these pumps alongside internationally established devices.
The stated aims of the consensus are to standardize perioperative care, reduce procedure-related complications, and improve outcomes in adults with end-stage heart failure undergoing LVAD implantation. By integrating international evidence with Chinese clinical experience and evidence involving domestically developed LVADs, the authors suggest that the recommendations may improve the consistency and quality of perioperative care in China.
The panel is explicit that the consensus is a starting point rather than a final verdict on effectiveness. The conclusions state that further evaluation is needed to determine the effects of the recommendations on postoperative complications and survival. As with any expert consensus, the document represents planned, structured guidance based on synthesis of existing evidence and expert agreement, and its real-world impact on patient outcomes will depend on future studies that test how the recommendations perform when implemented in clinical practice.
The consensus was published as an open-access review article on 28 August 2026, making the full recommendations available to clinicians and researchers. For centers in China beginning to work with domestically developed LVADs, the document offers a structured, evidence-informed pathway covering the full arc of care, from patient selection and right ventricular assessment before surgery, through hemodynamic and blood-management strategies in the operating room, to analgesia and recovery protocols afterward.
Subject of Research: An expert consensus on standardized perioperative management of adults undergoing left ventricular assist device implantation in China.
Article Title: 2026 Chinese expert consensus on perioperative management for left ventricular assist device implantation in adults
Article References: Guo, J., Kang, W., Han, J., & Yuan, S. (2026). 2026 Chinese expert consensus on perioperative management for left ventricular assist device implantation in adults. Anesthesiology and Perioperative Science, 4(1), Article 42. https://doi.org/10.1007/s44254-026-00189-8
Image Credits: AI Generated
DOI: 10.1007/s44254-026-00189-8
Keywords: LVAD, perioperative care, expert consensus, heart failure, anesthesiology, right ventricular function, ERAS, GRADE, China, cardiothoracic surgery, clinical guidelines, hemodynamics
News Source: Ophelia Keating. (October 29, 2026). Chinese Experts Issue Consensus on Perioperative Care for Adult LVAD Implantation. Scienmag.
