A preliminary investigation of symptom pattern and prevalence before and up to 6 months after implantation of a left ventricular assist device

Casida, Jesus; Parker, Jessica

doi:10.1007/s10047-011-0622-4

Cited by 17 publications

(10 citation statements)

References 18 publications

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“…QOL was negatively correlated with sleepiness and positively correlated with daytime function. (42) Sleepiness was found to improve from baseline (1 month post-implantation) to time 2 (6 months), though LVAD patients were still more sleepy at 6 months post-implantation than the age-adjusted norms. Sleep disturbance has been directly related to symptoms of cardiopulmonary congestion and pain in heart failure patients.…”

Section: Interventions To Improve Functional Statusmentioning

confidence: 85%

“…Individuals living with LVAD struggled after discharge with bathing independently, interrupted sleep and returning to pleasurable and meaningful activities including sexual intercourse and driving, which negatively affected both functional status and QOL. (42–47) These findings suggest a need to further explore the specific stressors that cause functional limitations and trouble LVAD patients.…”

Section: Interventions To Improve Functional Statusmentioning

confidence: 99%

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Functional Status in Left Ventricular Assist Device–Supported Patients: A Literature Review

Abshire

Himmelfarb

Russell

2014

Journal of Cardiac Failure

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The prevalence of advanced heart failure (HF) is increasing due to the aging population and improvements in HF management strategies. Left Ventricular Assist Device (LVAD) technology and management continue to advance rapidly and it is anticipated that the number of LVAD implants will increase. LVADs have been demonstrated to extend life and improve outcomes in patients with advanced HF. The purpose of this article is to review and synthesize the evidence on impact of LVAD therapy on functional status. Significant functional gains were demonstrated in patients supported by LVAD throughout the first year with most improvement in distance walked and peak oxygen consumption demonstrated in the first 6 months. Interventions to enhance exercise performance have had inconsistent effects on functional status. Poor exercise performance was associated with increased risk of adverse events. Functional status improved with LVAD therapy, though performance remained substantially reduced compared to age adjusted norms. There is tremendous need to enhance our understanding of factors influencing functional outcomes in this high-risk population.

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Section: Interventions To Improve Functional Statusmentioning

confidence: 85%

Section: Interventions To Improve Functional Statusmentioning

confidence: 99%

Functional Status in Left Ventricular Assist Device–Supported Patients: A Literature Review

Abshire

Himmelfarb

Russell

2014

Journal of Cardiac Failure

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“…38–40 BTT patients struggle with the uncertainties of donor organ availability and the possibility of dying awaiting transplantation. 40 Psychiatric conditions may be even more pronounced in DT patients—they have no hope of transplantation and must indefinitely comply with a complex medical regimen, including the technically difficult task of caring for the device.…”

Section: Discussionmentioning

confidence: 99%

Prospective, Multicenter Study of Ventricular Assist Device Infections

et al. 2013

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Background Ventricular assist devices (VADs) improve survival and quality of life in patients with advanced heart failure, but their use is frequently complicated by infection. There are limited data on the microbiology and epidemiology of these infections. Methods and Results 150 patients scheduled for VAD implantation were enrolled (2006–2008) at 11 U.S. cardiac centers and followed prospectively up to transplantation, explantation for recovery, death, or for one year. 86 (57%) patients received Heartmate II® devices. Data were collected on potential pre-, intra-, and post-operative risk factors for infection. Clinical, laboratory, and microbiologic data were collected for suspected infections and evaluated by an infectious diseases specialist. 33 (22%) subjects developed 34 VAD-related infections with an incidence rate of 0.10 per 100 person-days (95% CI, 0.073–0.142). The median time to infection was 68 days. The driveline was the most commonly infected site (n=28); 18 (64%) were associated with invasive disease. Staphylococci were the most common pathogen (47%), but Pseudomonas or other Gram-negative bacteria caused 32% of infections. A history of depression and elevated baseline serum creatinine were independent predictors of VAD infection (HRadj=2.8,P=0.007 and HRadj=1.7,P=0.023, respectively). The Heartmate II® was not associated with a decreased risk of infection. VAD infection increased one-year mortality (HRadj=5.6, P<0.0001). Conclusions This prospective, multicenter study demonstrates that infection frequently complicates VAD placement and is a continuing problem despite the use of newer, smaller devices. Depression and renal dysfunction may increase the risk of VAD infection. VAD infection is a serious consequence as it adversely affects patient survival.

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“…They suggested that patients had improved their health status, anxiety, and depression in the first few months after LVAD implantation and that those scores of patients receiving LVAD therapy were still below for physical, social, and emotional functioning compared with transplant recipients. After Brouwer's study, some studies [28,29] found decreasing of anxiety/depression after introducing LVADs, but two studies [30,31], whose sample size were about 10, did not found the significant improvement in anxiety and depression. Higher scores on anxiety/ depression over time were associated with poor health status [32] and rehospitalization [33].…”

Section: Brouwers Et Al Reviewed Systematically 16 Quantitative Studmentioning

confidence: 99%

Anxiety and Depression in Cardiovascular Surgery

Okamoto¹,

Motomura²

2017

Depression

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Although anxiety and depression are psychological risk factors for coronary artery disease (CAD), psychological aspect in patients with cardiovascular surgery has been less considered. Cognitive and psychological deficit has been still concerning in spite of notable improvement of cardiovascular surgery using cardiopulmonary bypass perfusion. The purpose of this chapter review is to discuss recent data concerning the prevalence and trend of anxiety and depression of patients with cardiovascular surgery and to introduce the nonpharmacological intervention studies. The prevalence of anxiety and depression of patients after cardiovascular surgeries has varied from 10 to 60% and has been likely higher than that of general people. From the limited studies about patients over 6 months after surgery, we guessed the followings about the trends of anxiety and depression of patients with CABG without any other additional intervention programs before/after surgery: (1) patients improved scores of anxiety and depression 3-6 months after surgery, (2) anxiety decreased considerably for about 6 months after CABG and then leveled out for some time, (3) depression remained a bit higher 6 months and more after CABG. Patients' longitudinal psychological conditions would have been influenced by not only invasive cardiovascular surgery but also life events. The nonpharmacology intervention would have improved patients' psychological conditions. Further research is needed to clarify the long-term psychological outcome and to develop the effective intervention programs toward patients with cardiovascular surgery.

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A preliminary investigation of symptom pattern and prevalence before and up to 6 months after implantation of a left ventricular assist device

Cited by 17 publications

References 18 publications

Functional Status in Left Ventricular Assist Device–Supported Patients: A Literature Review

Functional Status in Left Ventricular Assist Device–Supported Patients: A Literature Review

Prospective, Multicenter Study of Ventricular Assist Device Infections

Anxiety and Depression in Cardiovascular Surgery

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