Resource Utilization and Forecasting in Heart Failure Patients with Durable Left Ventricular Assist Devices

Heart failure patients treated with durable left ventricular assist devices (LVADs) require significant resource utilization. Patient volume and contact points based on implant volume remain poorly quantified. We retrospectively reviewed 268 patients implanted with a durable LVAD at a single, experienced center from 2011 through 2022 and recorded survival, telephone encounters, office visits, and all-cause hospitalizations. Telephone encounters peaked at 10.4 per patient-month and declined to approximately 5 after 24 months; 66% were anticoagulation-related. Office visits peaked at 3.0 per patient-month and declined to approximately 0.7 after 18 months. Hospitalizations decreased from 2.7 per patient-year in year 1 to approximately 1 by year 5. Five-year survival with HeartMate 3 (HM3) was 61.4%. Applying HM3 survival to constant annual implant volumes yielded estimated 5-year censuses of 39, 96, and 193 surviving patients for 10, 25, and 50 annual implants, respectively. These findings may inform LVAD program capacity and staffing.