Related Experiment Videos
Extended cardiac support with a portable left ventricular assist system in the home
T J Myers1, K A Catanese, R L Vargo
1Texas Heart Institute/St. Luke's Episcopal Hospital, Houston, USA.
Insights
Patients using the HeartMate vented electric (VE) left ventricular assist system (LVAS) can safely await heart transplantation at home. This study shows home support reduces hospitalizations and improves quality of life.
Area of Science:
- Cardiology
- Medical Devices
- Transplantation Medicine
Background:
- The HeartMate left ventricular assist system (LVAS) has been a crucial bridge to transplantation since 1986.
- Vented electric (VE) LVAS technology enables extended patient support.
- Evaluating home-based care for LVAS patients is essential for optimizing transplantation pathways.
Purpose of the Study:
- To assess the safety and feasibility of allowing patients with HeartMate VE-LVAS to await heart transplantation at home.
- To evaluate the incidence of adverse events and changes in quality of life during home-based LVAS support.
- To determine the impact of home discharge on patient lifestyle and employment.
Main Methods:
- A multicenter study involving 29 patients supported by HeartMate VE-LVAS.
- Patients progressed through supervised home passes (1-day and 3-day) before hospital discharge.
- Data collection focused on adverse events, readmissions, and quality of life metrics.
Main Results:
- Patients spent a total of 2,922 days at home, with 21 discharged.
- 15 readmissions occurred (9 medical, 6 device-related), with no out-of-hospital deaths.
- Patients reported improved quality of life, with some returning to full-time employment and active lifestyles.
Conclusions:
- Home support with HeartMate VE-LVAS is a safe option for patients awaiting transplantation.
- Adverse events can be managed effectively, and patients can maintain an active lifestyle.
- This approach offers a viable alternative to prolonged hospital stays, improving patient well-being.
Abstract:
Since 1986, the HeartMate left ventricular assist system (LVAS) has been widely used as a bridge to transplantation. Recently, a multicenter study was undertaken to evaluate the safety of allowing patients supported by the vented electric (VE) LVAS to await transplantation at home. Eligible patients progressed from 1 day to 3 day passes, then were discharged from the hospital. Twenty-nine patients at four centers were evaluated for incidence of adverse events and change in quality of life. Mean time of support was 193.7 +/- 138 days (range, 35-504 days). Patients spent a total of 2,922 days at home: 344 1 day passes and 150 3 day passes were issued; 21 patients were discharged from the hospital. There were 15 readmissions to the hospital: 9 for medical reasons and 6 for device related problems. Patients were able to resolve numerous technical problems at home. No deaths occurred outside of the hospital. Two patients returned to full-time employment, and all patients resumed an active lifestyle. Although adverse events occurred, the results of this study appear to demonstrate that patients may safely await transplantation at home while supported by a HeartMate VE-LVAS.