Chapters authored
Perspective Chapter: Delivering LVAD Care to the Local Community
Heart failure is a growing pandemic affecting approximately 6.2 million people in the US and 15 million people worldwide. Mechanical circulatory support devices are not only a bridge to transplantation, but have become destination therapy for a large portion of this population. Given its prevalence and high morbidity and mortality leading to significant financial burden on our healthcare system, establishing strategies focused on improving therapeutic outcomes and prognosis should be prioritized. Delivering care to such a large and complex patient population poses unique challenges given the progressive care needs and extensive follow-up. Time and distance traveled are among the limiting factors that disable patients from having access to life sustaining advanced therapies such as the LVAD. This chapter aims to review the traditional care model and expand on the necessary tools and benefits of the LVAD shared care model in delivering care to previously underserved patient populations with advanced heart failure.
Part of the book: Ventricular Assist Devices
LVAD Continuing Care: A Comprehensive Guide to Long-Term Support and Management
Heart failure is a growing pandemic with a rising societal burden. Heart failure affects 3.6 million people in Europe and 5 million in the United States annually. The United States alone spends 30.7 billion annually managing heart failure, and that number is expected to eclipse 70 billion by 2030. Many people are not orthotopic heart transplant candidates, and many who are may not live long enough to receive a transplant. As a result, durable left ventricular assist devices (LVAD) have become both a bridging therapy and a destination therapy, necessitating a robust continuing care system. LVAD programs are expanding to fill this need. This chapter aims to cover the spectrum of LVAD continuing care from initial implantation to the outpatient clinic. This chapter will cover essential care practices for maintaining LVAD function, including driveline care, battery management, and alarm response/tracking. Troubleshooting the common issues and complications patients might experience, such as low flow alarms, bleeding, infection, and right heart failure. Emphasize the importance of the primary caregiver’s involvement and how to prepare them by providing resources for education, training, and ongoing support. Lastly, it will cover ethical concerns and the role of palliative care in the process.
Part of the book: End Stage Therapy and Heart Transplantation