Establishing a New Left Ventricular Assist Device Program: From Concept to Reality.

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Device Technology

Background:

• Left ventricular assist devices (LVADs) are crucial for advanced heart failure treatment.
• LVAD implantation is typically performed at heart transplant centers.
• LVADs serve as destination therapy or a bridge to heart transplantation.

Purpose of the Study:

• To detail the process of establishing a novel LVAD program at a non-heart transplant center.
• To present the initial short- and long-term outcomes of the first 25 LVAD patients.

Main Methods:

• Program establishment involved needs assessment, team formation, and protocol development (pre-operative, intra-operative, post-operative, outpatient).
• Collaboration with an established heart transplant center was initiated early.
• Emphasis was placed on meticulous patient selection, initially focusing on lower-risk individuals.

Main Results:

• The study analyzed the first 25 LVAD patients.
• The initial five patients survived over two years without major complications.
• One operative death occurred due to gastrointestinal bleeding; four late deaths resulted from septic events.

Conclusions:

• Successful LVAD program implementation is achievable in smaller and medium-sized centers.
• Meticulous planning facilitates the expansion of LVAD implantation to more facilities.
• LVADs offer a viable treatment option for a broader range of advanced heart failure patients.