Sexual concerns in patients with heart transplantation and left ventricular assist devices: A subject clinicians should care about

Abstract

Data on the quality of sex life of left ventricular assist device (LVAD) and heart transplant (HTx) recipients are scarce, with the literature focusing primarily on survival, technical development, and physiologic aspects. The objective of this study is to evaluate the sexuality of these patients, to better appreciate and understand the patients’ feelings in their daily lives and with the objective of better meeting their expectations. It would thus be possible to provide our patients answers to these problems, through better training of health professional or the development of patient guides with the help of learned societies. A postal survey was carried out in January 2020 at the Rennes university hospital for ambulatory HTx patients (multicenter with the Toulouse, Grenoble, Lyon, Dijon and Paris university hospitals for LVAD patients) using Homemade questionnaire, validated in our center. Forty-eight LVAD patients and 124 HTx patients completed this questionnaire. Sexuality is less resumed (43.7% vs. 75%, P = 0.0002) and more altered (95% vs. 31.8%, P < 0.0001) in LVAD patients. Feelings about the sentimental relationship with the partner, sexual desire, frequency of intercourse, and partner satisfaction of LVAD patients remain significantly impaired compared with heart transplant patients. Sexual dysfunctions are greatly aggravated after surgery in the 2 populations and too little attention is paid to them. The majority of the patients avoid discussing this issue with their physicians (74.4% for LVAD patients – 84.5% for HTx patients). Our study provides exhaustive and new data regarding sexuality in these populations, which is more altered in LVAD patients compared to transplant patients. These results could improve the care of these patients by enriching the spectrum of management beyond survival and mortality data alone. An external validation of our questionnaire could also allow a harmonization of practices.