Continuous flow left ventricular assist devices: shared care goals of monitoring and treating patients

Methodist Debakey Cardiovasc J. 2015 Jan-Mar;11(1):33-44. doi: 10.14797/mdcj-11-1-33.

Abstract

Continuous-flow left ventricular assist devices (CF-LVADs) have been clinically adopted as a long-term standard of care therapy option for patients with end-stage heart failure. For many patients, shared care between the care providers at the implanting center and care providers in the community in which the patient resides is a clinical necessity. The aims of this review are to (1) provide a rationale for the outpatient follow-up exam and surveillance testing used at our center to monitor patients supported by the HeartMate II(®) CF-LVAD (Thoratec Corporation, Pleasanton, CA) and (2) provide the protocol/algorithms we use for blood pressure, driveline exit site, LVAD alarm history, surveillance blood work, and echocardiography monitoring in this patient population. In addition, we define our partnership outpatient follow-up protocol and the "shared care" specific responsibilities we use with referring health care providers to best manage many of our patients.

Keywords: continuous flow LVAD; heart failure; left ventricular assist device; shared care.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Continuity of Patient Care / organization & administration*
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / mortality
  • Heart Failure / surgery*
  • Heart-Assist Devices*
  • Humans
  • Male
  • Monitoring, Physiologic / methods
  • Patient Care Planning / organization & administration*
  • Patient Care Team / organization & administration
  • Patient Outcome Assessment*
  • Prognosis
  • Time Factors