Current Technology: Devices Available for Destination Therapy

Takayama, Hiroo; Yang, Jixiang; Naka, Yoshifumi

doi:10.1016/j.ccl.2011.08.005

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…3 An estimated 150,000-250,000 patients each year could be eligible for DT LVAD from the more than 6,000,000 in the United States with chronic heart failure. 4-6 With an increasing prevalence of heart failure, 5 limited availability of suitable donor hearts, 7 and ongoing improvements in LVAD technology, 8 DT LVAD is likely to become an increasingly viable treatment option for this expanding patient population. 4 …”

Section: Introductionmentioning

confidence: 99%

Perspectives from mechanical circulatory support coordinators on the pre-implantation decision process for destination therapy left ventricular assist devices

et al. 2015

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Objective To understand mechanical circulatory support (MCS) coordinators’ perspectives related to destination therapy left ventricular assist devices (DT LVAD) decision making Background MCS coordinators are central to the team that interacts with patients considering DT LVAD, and are well positioned to comment upon the pre-implantation process. Methods From August 2012–January 2013, MCS coordinators were recruited to participate in semi-structured, in-depth interviews. Established qualitative approaches were used to analyze and interpret data. Results Eighteen MCS coordinators from 18 programs were interviewed. We found diversity in coordinators’ roles and high programmatic variability in how DT LVAD decisions are approached. Despite these differences, three themes were consistently recommended: 1) DT LVAD is a major patient-centered decision: “you’re your best advocate…this may not be the best choice for you”; 2) this decision benefits from an iterative, multidisciplinary process: “It is not a one-time conversation”; and 3) this process involves a tension between conveying enough detail about the process yet not overwhelming patients: “It’s sometimes hard to walk that line to not scare them but not paint a rainbow and butterflies picture.” Conclusions MCS coordinators endorsed a shared decision-making process that starts early, uses non-biased educational materials, and involves a multidisciplinary team sensitive to the tension between conveying enough detail about the therapy yet not overwhelming patients.

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