Palliative Care Clinicians Caring for Patients Before and After Continuous Flow-Left Ventricular Assist Device

Sara E. Wordingham, Colleen K. McIlvennan, Timothy J. Fendler, Amy L. Behnken, Shannon M. Dunlay, James N. Kirkpatrick, Keith M. Swetz

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)601-608
Number of pages8
JournalJournal of pain and symptom management
Volume54
Issue number4
DOIs
StatePublished - Oct 2017

Keywords

  • Mechanical circulatory support
  • advance care planning
  • end of life
  • medical ethics
  • palliative care
  • ventricular assist device

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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