Guidance on the management of left ventricular assist device <scp>(LVAD)</scp> supported patients for the non‐ <scp>LVAD</scp> specialist healthcare provider: executive summary
Tuvia Ben Gal, Binyamin Ben Avraham, Davor Miličić, María G. Crespo‐Leiro, Andrew J.S. Coats, Giuseppe Rosano, Petar Seferović, Frank Ruschitzka, Marco Metra, Stefan D. Anker, Gerasimos Filippatos, Johann Altenberger, Stamatis Adamopoulos, Yaron D. Barac, Ovidiu Chioncel, Nicolaas de Jonge, Jeremy Elliston, Maria Frigerio, Eva Gonçalvesová, Israel Gotsman, Avishai Grupper, Righab Hamdan, Yoav Hammer, Tal Hasin, Loreena Hill, Osnat Itzhaki Ben Zadok, Miriam Abuhazira, Jacob Lavee, Wilfried Müllens, Sanem Nalbantgil, Massimo Piepoli, Piotr Ponikowski, Luciano Potena, Arsen Ristić, Arjang Ruhparwar, Aviv A. Shaul, Laurens F. Tops, Steven Tsui, Stephan Winnik, Tiny Jaarsma, Finn Gustafsson
Abstract
The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD supported patients. Device-related, and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of LVAD implanting centres. The probability of an LVAD supported patient presenting with medical emergency to a local ambulance team, emergency department medical team and internal or surgical wards in a non-LVAD implanting centre is increasing. The purpose of this paper is to supply the immediate tools needed by the non-LVAD specialized physician - ambulance clinicians, emergency ward physicians, general cardiologists, and internists - to comply with the medical needs of this fast-growing population of LVAD supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department, and from the emergency department to the internal or surgical wards and eventually back to the general practitioner.