Hello and welcome back to AckRack. I'm Jed Wolpa and I am really thrilled today. And I know I say

that at the beginning of every episode, but I have to say that I have an extra little bit of

thrill today because I have with me one of my former residents, former chief residents who went on

to do a cardiac anesthesiology fellowship and is now a cardiac anesthesia attending, just an

all around awesome guy. I'd be thrilled to just be having coffee with him, but even more thrilled

that he has agreed to come on the show and do a really important topic. So I would love to welcome

Dr. Kia Sedgie to the show. And we're going to talk about the perioperative anesthetic management

of patients with LVADs who are coming in for non-cardiac surgery. I think this is going to be really

key. We're going to be seeing more of it. And those of us who aren't trained in cardiac surgery

anesthesia are going to have to be doing these. So I think this will be really useful.

Kia, thank you so much and welcome to the show. And thanks very much for having me, Jed. I got to say

as an early listener of the AckRack podcast, it's very exciting for me to be here, both as a fan

and as a presenter. So thank you for having me. Well fantastic. Great, great, great to have you

and to see you in general. So how do you want to start? So I thought we could first start with

a case. Just because I think as a case presentation, this is often how we'll see patients coming into

the OR, whether it's overnight when you're on call or if you're preparing for the next day. So

we have a 65 year old male with a past medical history that's significant for hypertension,

hyperlipidemia, diabetes, coronary artery disease, complicated by ischemic cardiomyopathy,

and heart failure with reduced ejection fraction status post a heart mate three implantation in

2020, presenting for England or hernia repair. Now if you heard that last part, got a little anxious,

maybe your palms got somewhat sweaty, your knees maybe a bit weak, your arms kind of heavy,

then don't worry because that's totally normal. And today I hope to do the following. So we're

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