Shared Care Program for Left Ventricular Assist Device (LVAD) Patients: Clinical Experience and Interim Report

Abstract

<h3>Purpose</h3> Left Ventricular Assist Devices (LVAD) improve the survival and quality of patients with advanced heart failure. LVAD implant centers are frequently located remotely from patients' homes, which can be challenging when frequent follow-up is required. Shared care is a system where care these patients are managed by a collaboration between the implanting center and local, shared-care sites. This study aimed to assess the outcome of patients treated in a shared care model <h3>Methods</h3> Retrospective analysis of all patients implanted with a LVAD at a large academic center between 1/2015-9/2021 and were treated in a shared care model. <h3>Results</h3> 30 LVAD patients were identified for the analysis. The mean age was 61±10 years, 24 (80%) were men, and the median time of follow-up was 741 (IQR 398, 1381) days. Most patients were implanted as destination therapy (21, 70%), and 16 (53%) received a HeartMate III LVAD. During follow-up, 6 (20%) patients died at a median follow-up of 743 (IQR 403,1371) days, 7 (23%) were transplanted at a median follow-up of 739 (IQR 398,1338) days, and 17 (56%) are alive (Figure). 9 (30%) patients had major bleeding events, 6 (20%) had driveline infections, and 3 (10%) had device malfunction and 3 (10%) had device thrombosis. <h3>Conclusion</h3> A shared care model is a feasible and effective way to care for LVAD patients who live far from their implanting center. In this study, adverse outcomes occurred in this population at an expected rate.