ESC Heart Failure (Dec 2021)
Heart Failure Association of the European Society of Cardiology position paper on the management of left ventricular assist device‐supported patients for the non‐left ventricular assist device specialist healthcare provider: Part 2: at the emergency department
- Davor Milicic,
- Binyamin Ben Avraham,
- Ovidiu Chioncel,
- Yaron D. Barac,
- Eva Goncalvesova,
- Avishai Grupper,
- Johann Altenberger,
- Maria Frigeiro,
- Arsen Ristic,
- Nicolaas De Jonge,
- Steven Tsui,
- Jacob Lavee,
- Giuseppe Rosano,
- Marisa Generosa Crespo‐Leiro,
- Andrew J.S. Coats,
- Petar Seferovic,
- Frank Ruschitzka,
- Marco Metra,
- Stefan Anker,
- Gerasimos Filippatos,
- Stamatis Adamopoulos,
- Miriam Abuhazira,
- Jeremy Elliston,
- Israel Gotsman,
- Righab Hamdan,
- Yoav Hammer,
- Tal Hasin,
- Lorrena Hill,
- Osnat Itzhaki Ben Zadok,
- Wilfried Mullens,
- Sanemn Nalbantgil,
- Massimo Francesco Piepoli,
- Piotr Ponikowski,
- Luciano Potena,
- Arjang Ruhparwar,
- Aviv Shaul,
- Laurens F. Tops,
- Stephan Winnik,
- Tiny Jaarsma,
- Finn Gustafsson,
- Tuvia Ben Gal
Affiliations
- Davor Milicic
- Department for Cardiovascular Diseases, Hospital Center Zagreb University of Zagreb Zagreb Croatia
- Binyamin Ben Avraham
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’ Bucharest Romania
- Yaron D. Barac
- Department of Cardiothoracic Surgery, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Eva Goncalvesova
- Odd. Srdcovehozlyhavania a Transplantacie Bratislava Slovakia
- Avishai Grupper
- Heart Failure Institute Lev Leviev Heart Center, Chaim Sheba Medical Center Tel HaShomer Israel
- Johann Altenberger
- SKA‐Rehabilitationszentrum Großgmain Großgmain Austria
- Maria Frigeiro
- Transplant Center and De Gasperis Cardio Center Niguarda Hospital Milan Italy
- Arsen Ristic
- Department of Cardiology of the Clinical Center of Serbia Belgrade University School of Medicine Belgrade Serbia
- Nicolaas De Jonge
- Department of Cardiology University Medical Center Utrecht Utrecht The Netherlands
- Steven Tsui
- Transplant Unit Royal Papworth Hospital Cambridge UK
- Jacob Lavee
- Heart Transplantation Unit, Leviev Cardiothoracic and Vascular Center Sheba Medical Center Ramat Gan Israel
- Giuseppe Rosano
- Centre for Clinical and Basic Research Department of Cardiac & Pulmonary Rehabilitation Sciences, IRCCS San Raffaele Pisana Rome Italy
- Marisa Generosa Crespo‐Leiro
- Complexo Hospitalario Universitario A Coruña (CHUAC), CIBERCV, Instituto de Investigacion Biomedica A Coruña (INIBIC) Universidade da Coruña (UDC) A Coruña Spain
- Andrew J.S. Coats
- Faculty of Medicine University of Warwick Coventry UK
- Petar Seferovic
- Serbian Academy of Sciences and Arts, Heart Failure Center, Faculty of Medicine Belgrade University Medical Center Belgrade Serbia
- Frank Ruschitzka
- Department of Cardiology, University Hospital University Heart Center Zürich Switzerland
- Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy
- Stefan Anker
- Department of Cardiology (CVK) Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin Berlin Germany
- Gerasimos Filippatos
- Heart Failure Unit, Attikon University Hospital National and Kapodistrian University of Athens Athens Greece
- Stamatis Adamopoulos
- Heart Failure and Heart Transplantation Unit Onassis Cardiac Surgery Center Athens Greece
- Miriam Abuhazira
- Department of Cardiothoracic Surgery, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Jeremy Elliston
- Anesthesiology Department, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Israel Gotsman
- Heart Institute Hadassah University Hospital Jerusalem Israel
- Righab Hamdan
- Department of Cardiology Beirut Cardiac Institute Beirut Lebanon
- Yoav Hammer
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Tal Hasin
- Jesselson Integrated Heart Center Shaare Zedek Medical Center Jerusalem Israel
- Lorrena Hill
- School of Nursing and Midwifery Queen's University Belfast UK
- Osnat Itzhaki Ben Zadok
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Wilfried Mullens
- Ziekenhuis Oost‐Limburg Genk Belgium
- Sanemn Nalbantgil
- Department of Cardiology Ege University Hospital İzmir Turkey
- Massimo Francesco Piepoli
- Heart Failure Unit, Cardiology G. da Saliceto Hospital Piacenza Italy
- Piotr Ponikowski
- Centre for Heart Diseases University Hospital Wrocław Poland
- Luciano Potena
- Heart and Lung Transplant Program Bologna University Hospital Bologna Italy
- Arjang Ruhparwar
- Department of Cardiac Surgery University of Heidelberg Heidelberg Germany
- Aviv Shaul
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Laurens F. Tops
- Department of Cardiology Leiden University Medical Center Leiden The Netherlands
- Stephan Winnik
- Department of Cardiology, University Heart Center University Hospital Zürich Zürich Switzerland
- Tiny Jaarsma
- Department of Nursing, Faculty of Medicine and Health Sciences Linköping University Linköping Sweden
- Finn Gustafsson
- Department of Cardiology Rigshospitalet Copenhagen Denmark
- Tuvia Ben Gal
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- DOI
- https://doi.org/10.1002/ehf2.13587
- Journal volume & issue
-
Vol. 8,
no. 6
pp. 4409 – 4424
Abstract
Abstract The improvement in left ventricular assist device (LVAD) technology and scarcity of donor hearts have increased dramatically the population of the LVAD‐supported patients and the probability of those patients to present to the emergency department with expected and non‐expected device‐related and patient–device interaction complications. The ageing of the LVAD‐supported patients, mainly those supported with the ‘destination therapy’ indication, increases the risk for those patients to suffer from other co‐morbidities common in the older population. In this second part of the trilogy on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider, definitions and structured approach to the LVAD‐supported patient presenting to the emergency department with bleeding, neurological event, pump thrombosis, chest pain, syncope, and other events are presented. The very challenging issue of declaring death in an LVAD‐supported patient, as the circulation is artificially preserved by the device despite no other signs of life, is also discussed in detail.
Keywords