Shared care for patients with a left ventricular assist device: a scoping review

Area of Science:

• Cardiology
• Medical Technology
• Healthcare Management

Background:

• Left ventricular assist devices (LVADs) are crucial for advanced heart failure but concentrated care presents access challenges.
• Shared care models (SCMs) propose collaboration between specialized implanting centers and local hospitals for LVAD management.
• Increasing LVAD utilization necessitates exploring efficient and accessible patient care strategies.

Purpose of the Study:

• To conduct a scoping review synthesizing evidence on the application of SCMs in LVAD patient care.
• To identify the benefits and challenges associated with implementing SCMs for LVAD management.
• To assess the current state of evidence regarding SCMs' impact on LVAD patient outcomes and healthcare systems.

Main Methods:

• A comprehensive literature search was performed across major databases (EMBASE, PubMed MEDLINE, Web of Science, Cochrane, Google Scholar).
• Studies were screened and selected based on eligibility criteria, with findings synthesized following PRISMA-ScR guidelines.
• Five relevant articles were identified and analyzed, including four reviews and one prospective study.

Main Results:

• SCMs offer potential benefits such as enhanced patient satisfaction and continuity of care.
• Key challenges include the initial education of non-implanting staff and maintaining clinical competency.
• Limited evidence suggests that a lack of LVAD-specific care may be linked to poorer survival and increased complications like pump thrombosis and infections.

Conclusions:

• Shared care models represent a promising strategy for the long-term management of LVAD patients.
• Current evidence is insufficient to fully ascertain the impact of SCMs on patient outcomes and healthcare systems.
• Development of standardized protocols, informed by prospective studies, is essential for safe and effective shared LVAD care.