TY - JOUR
T1 - Palliative Care Clinicians Caring for Patients Before and After Continuous Flow-Left Ventricular Assist Device
AU - Wordingham, Sara E.
AU - McIlvennan, Colleen K.
AU - Fendler, Timothy J.
AU - Behnken, Amy L.
AU - Dunlay, Shannon M.
AU - Kirkpatrick, James N.
AU - Swetz, Keith M.
N1 - Publisher Copyright:
© 2017
PY - 2017/10
Y1 - 2017/10
N2 - Left ventricular assist devices (LVADs) are an available treatment option for carefully selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. Although survival and quality of life improve with LVADs compared with medical therapy, complications persist including bleeding, infection, and stroke. There has been increased emphasis on involving palliative care (PC) specialists in LVAD programs, specifically the DT-LVAD population, from the pre-implantation process through the end of life. Palliative care specialists are well poised to provide education, guidance, and support to patients, families, and clinicians throughout the LVAD journey. This article addresses the complexities of the LVAD population, describes key challenges faced by PC specialists, and discusses opportunities for building collaboration between PC specialists and LVAD teams.
AB - Left ventricular assist devices (LVADs) are an available treatment option for carefully selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. Although survival and quality of life improve with LVADs compared with medical therapy, complications persist including bleeding, infection, and stroke. There has been increased emphasis on involving palliative care (PC) specialists in LVAD programs, specifically the DT-LVAD population, from the pre-implantation process through the end of life. Palliative care specialists are well poised to provide education, guidance, and support to patients, families, and clinicians throughout the LVAD journey. This article addresses the complexities of the LVAD population, describes key challenges faced by PC specialists, and discusses opportunities for building collaboration between PC specialists and LVAD teams.
KW - Mechanical circulatory support
KW - advance care planning
KW - end of life
KW - medical ethics
KW - palliative care
KW - ventricular assist device
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U2 - 10.1016/j.jpainsymman.2017.07.007
DO - 10.1016/j.jpainsymman.2017.07.007
M3 - Article
C2 - 28711755
AN - SCOPUS:85029527526
SN - 0885-3924
VL - 54
SP - 601
EP - 608
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 4
ER -