Palliative care and end-of-life issues in patients treated with left ventricular assist devices as destination therapy

Keith M. Swetz, Abigale L. Ottenberg, Monica R. Freeman, Paul S. Mueller

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Left ventricular assist devices as destination therapy (DT) improve quality of life for many patients with advanced heart failure. However, DT can be associated with risks such as infection, bleeding, and stroke, and may impose psychosocial strain on patients and caregivers. Furthermore, patients treated with DT eventually will die with their device in place whether death is related to the device or not. In response to these concerns, palliative medicine consultation has been suggested with standard DT care to improve focus on quality of life, symptom management, and end-of-life planning. This article reviews key issues associated with caring for patients with DT, including psychosocial, quality-of-life, caregiving, and ethical issues, and discusses end-of-life management of patients with DT, including practical considerations, but moreover, review topics regarding communication, symptom management, and provision of appropriate comfort care.

Original languageEnglish (US)
Pages (from-to)212-218
Number of pages7
JournalCurrent heart failure reports
Volume8
Issue number3
DOIs
StatePublished - Sep 1 2011

Keywords

  • Advance care planning
  • DT
  • Destination therapy
  • ESHF
  • End of life
  • End-stage heart failure
  • Heart failure
  • LVAD
  • Medical ethics
  • Palliative care
  • Patient-caregiver communication
  • Preparedness planning
  • Psychosocial issues
  • Quality of care
  • Quality of life
  • Ventricular assist device

ASJC Scopus subject areas

  • Emergency Medicine
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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