Related Experiment Video
Updated: May 2, 2026
05:18
Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026
232
Left ventricular assist device withdrawal: an ethical discussion
Sarah McLean1,2, Tara Ni Dhonnchu3, Niall Mahon4
1Palliative Care Service, St Francis Hospice, Dublin, Ireland.
BMJ Supportive & Palliative Care
|March 20, 2014
Summary
Specialist palliative care teams face ethical dilemmas when managing patients with advanced chronic heart failure (CHF) requiring left ventricular assist devices (LVADs). This case explores autonomy, consent, and futility in LVAD withdrawal for end-of-life care.
Area of Science:
- Palliative Care
- Cardiology
- Bioethics
Background:
- Increasing integration of specialist palliative care (SPC) with chronic heart failure (CHF) services.
- Left ventricular assist devices (LVADs) are an advancement in managing advanced CHF.
- LVADs present unique ethical challenges for SPC providers.
Purpose of the Study:
- To review ethical considerations in SPC for LVAD patients.
- To explore decision-making regarding LVAD withdrawal in end-of-life care.
- To examine the influence of patient and societal perceptions of LVADs on treatment withdrawal.
Main Methods:
- Case study analysis of a patient with advanced CHF treated with an LVAD.
- Review of ethical principles including autonomy, informed consent, and futility.
- Discussion of multi-disciplinary team and family involvement in decision-making.
Main Results:
- A patient with an LVAD experienced cerebral haemorrhages, leading to neurological deficits.
- Anticoagulation was contraindicated, necessitating transfer to SPC for symptom management.
- LVAD support was withdrawn after ethical review and family consultation, allowing peaceful death.
Conclusions:
- Ethical principles are crucial for navigating complex decisions in palliative care for LVAD recipients.
- The nature and perception of LVADs significantly impact end-of-life treatment withdrawal decisions.
- Shared decision-making involving patients, families, and healthcare teams is vital.
More Related Videos
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
753
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
753
01:22Heart Failure VI: Adjunct Therapies
632
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
632
01:27Ethical Issues
2.3K
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
2.3K
01:30Cardiomyopathy II: Dilated Cardiomyopathy
790
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
790
01:23Cardiopulmonary Resuscitation III: AED Use
1.7K
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
1.7K
01:30Heart Failure V: Medical Management
626
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
626