Abstract 16073: Quality of Life for Patients and Caregivers After Implantation of a Ventricular Assist Device

Abstract

Introduction: Ventricular Assist Device (VAD) implantation is a therapeutic option for many patients with advanced heart failure (HF). Although patient quality of life (QOL) generally improves after VAD, little is known about changes in QOL among caregivers of patients undergoing VAD implantation. Hypothesis: We hypothesized that patient QOL would improve and caregiver QOL would worsen after VAD implantation. Methods: This was a prospective longitudinal study of patients receiving VAD therapy for advanced HF and their informal caregivers (n=27 dyads). QOL was measured pre- VAD implant and at 30 and 90 days post-implant. For patients, QOL was measured with the Kansas City Cardiomyopathy Questionnaire. For caregivers, QOL was measured with the SF-36. Both measures range from 0-100; higher scores indicate better QOL. Pre vs. post VAD comparisons in QOL were examined using paired t-tests. Results: Caregivers and patients were 54.9±10.3 and 54.3±14.6 years of age, respectively. Most patients (88.9%) were male, and most (63.0%) were receiving a VAD as a bridge to transplant. A majority of caregivers were female (85.2%) and the patients’ spouses (77.8%). Patient QOL improved significantly from baseline (28.4±20.7) to 30 days (50.0±25.3; t=-4.1, p<0.01) and 90 days post-implant (62.7±20.0; t=-2.3, p=0.03). Caregiver QOL worsened significantly from baseline (55.2±7.1) to 30 days (51.9±10.3; t=2.4, p=0.03) and remained at that level at 90 days post-implant (52.1±1.9; t=0.3, p=0.76). Conclusions: Although VAD therapy is associated with QOL benefit for patients, clinicians and researchers should recognize that caregivers are at risk for significant worsening of QOL post-implant. Caregivers of patients undergoing VAD implantation may benefit from greater anticipatory guidance and ongoing support.