HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1: Introduction and at the non‐hospital settings in the community

Binyamin Ben Avraham, Marisa Generosa Crespo‐Leiro, Gerasimos Filippatos, Israel Gotsman, Petar Seferovic, Tal Hasin, Luciano Potena, Davor Milicic, Andrew J.S. Coats, Giuseppe Rosano, Frank Ruschitzka, Marco Metra, Stefan Anker, Johann Altenberger, Stamatis Adamopoulos, Yaron D. Barac, Ovidiu Chioncel, Nicolaas De Jonge, Jeremy Elliston, Maria FrigeiroEva Goncalvesova, Avishay Grupper, Righab Hamdan, Yoav Hammer, Loreena Hill, Osnat Itzhaki Ben Zadok, Miriam Abuhazira, Jacob Lavee, Wilfried Mullens, Sanemn Nalbantgil, Massimo F. Piepoli, Piotr Ponikowski, Arsen Ristic, Arjang Ruhparwar, Aviv Shaul, Laurens F. Tops, Steven Tsui, Stephan Winnik, Tiny Jaarsma, Finn Gustafsson, Tuvia Ben Gal*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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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 the LVAD‐supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD‐supported patients. The expected and non‐expected device‐related and patient–device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD‐supported patients, mainly those supported with the ‘destination therapy’ indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD‐supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non‐LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non‐LVAD specialized physician: ambulance clinicians, emergency ward physicians, general cardiologists, internists, anaesthesiologists, and surgeons, 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 to the discharge home from the hospital back to the general practitioner. In this first part of the trilogy on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider, after the introduction on the assist devices technology in general, definitions and structured approach to the assessment of the LVAD‐supported patient in the ambulance and emergency department is presented including cardiopulmonary resuscitation for LVAD‐supported patients.
Original languageEnglish
JournalECS Heart Failure
Early online date14 Sep 2021
DOIs
Publication statusEarly online date - 14 Sep 2021

Keywords

  • ESC and HFA Paper
  • ESC and HFA Papers
  • LVAD
  • General description
  • Emergency medical systems
  • CPR

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