Abstract
The novel coronavirus disease 2019 (COVID-19) is an infectious disease with multi-organ involvement, including the cardiovascular system. The disease may cause several cardiovascular complications, and may increase morbidity and mortality among patients with background cardiovascular disease. Patients with advanced heart failure are often treated with left ventricular assist device (LVAD), and represent a unique population mandating multi-disciplinary approach. Several aspects of COVID-19 should be taken into account in LVAD implants, including right ventricular involvement, hemodynamic alterations, thromboembolic and haemorrhagic complications, and the psychological effects of social isolation. Patients with VAD and suspected COVID-19 should be transferred to specialized centers for better management of complications. Here, we review the implications of COVID-19 pandemic on LVAD patients with our recommendations for appropriate management.
Highlights
Despite improvements in pharmacological and invasive therapies in heart failure, some patients still suffer from intractable disease with a need for advanced mechanical support or heart transplantation
Several considerations need to be taken into account while managing this unique population since hemodynamic and hematologic alterations that have been described in COVID-19 may critically affect Left ventricular assist device (LVAD) implants
Acute respiratory failure secondary to ARDS should be managed similar to other patients, with the exception that prone position may have some undesirable effects in LVAD implants
Summary
Despite improvements in pharmacological and invasive therapies in heart failure, some patients still suffer from intractable disease with a need for advanced mechanical support or heart transplantation. Left ventricular assist device (LVAD) is associated with improved survival among patients with advanced heart failure and may be used as a bridge to transplantation or as a destination therapy [1,2]. Implanted patients need to be managed by expert staff of clinicians, nurses, and coordinators. The novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome 2 virus (SARS-CoV-2) is associated with several cardiovascular complications and may increase morbidity and mortality among patients with background heart disease [3]. Similar to other cardiovascular patients, LVAD implants are at increased risk for complications during the acute infection. We summarize the effects of the current COVID-19 pandemic on LVAD patients
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