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Left ventricular assist as a viable alternative for cardiac transplantation
S R Chillcott1, P J Atkins, R M Adamson
1Sharp Memorial Hospital, San Diego, California, USA.
Insights
Left ventricular assist systems (LVASs) are increasingly used for end-stage heart disease. Permanent implantation is now an alternative to heart transplantation, offering extended support.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Technology
Background:
- Left ventricular assist systems (LVASs) are crucial for end-stage heart disease patients awaiting transplantation.
- Historically approved as a bridge to transplantation, LVASs now offer permanent implantation options.
- Extended bridging periods exceeding two years have driven the shift towards permanent LVAS use.
Purpose of the Study:
- To review the HeartMate Vented Electric LVAS components.
- To discuss patient complications and nursing implications associated with LVAS.
- To present the intraoperative implantation procedure and ethical/financial considerations for permanent LVAS.
Main Methods:
- Review of the HeartMate Vented Electric LVAS.
- Analysis of patient complications and nursing care.
- Description of the surgical implantation technique.
- Discussion of ethical and financial aspects of permanent implantation.
Main Results:
- Detailed examination of the HeartMate Vented Electric LVAS.
- Identification of potential patient complications and essential nursing interventions.
- Outline of the surgical implantation process.
- Exploration of ethical and financial factors impacting permanent LVAS decisions.
Conclusions:
- Permanent LVAS implantation is a viable alternative for end-stage heart disease.
- Comprehensive understanding of LVAS components, complications, and nursing care is vital.
- Ethical and financial considerations are paramount in permanent LVAS implantation decisions.
Abstract:
Implantation of left ventricular assist systems (LVASs) is becoming more prevalent for patients with end-stage heart disease who are awaiting cardiac transplantation. The original intent of the LVAS was to provide an alternative to transplantation, but until recently, the LVAS has been approved only as a bridge to transplantation. Now that bridging to transplantation for patients with LVASs has exceeded 2-year periods, permanent implantation is being done as an alternative to transplantation. This article reviews the fundamental components of the HeartMate Vented Electric LVAS (Thermo Cardiosystems, Inc, Woburn, MA) with a focus on patient complications and nursing implications. Additionally, the intraoperative implantation procedure is presented. Finally, ethical and financial considerations related to permanent LVAS implantation are discussed.