Inpatient Specialist Palliative Care in Patients With Left Ventricular Assist Devices (LVAD): A Retrospective Case Series

• DOI: 10.3389/fcvm.2022.879378
• Publication Date: 2022-06-30T11:33:25Z
• Authors: Theresa Tenge; David Santer; Daniel Schlieper; Manuela Schallenb...; Jacqueline Schwartz; Stefan Meier; Payam Akhyari; Otmar Pfister; Silke Walter; Sandra Eckstein; Friedrich Eckstein; Martin Siegemund; Jan Gaertner; Martin Neukirchen
• Keywords: Destination therapy

Repeat hospitalizations, complications, and psychosocial burdens are common in patients with left ventricular assist devices (LVAD). Specialist palliative care (sPC) involvement supports during decision-making until end-of-life. In the United States, guidelines recommend early specialist (esPC) prior to implantation. Yet, data about sPC esPC Europe scarce.This is a retrospective descriptive study of deceased LVAD who had received their LVAD-related admissions two university hospitals Duesseldorf, Germany Basel, Switzerland from 2010 2021. The main objectives were assess: To which extent have sPC, how involved? What characteristics those, did take place what key challenges end-of-life care?In total, 288 implanted LVAD, including 31 (11%). Twenty-two (19 male) included. Mean patient age at time implantation was 67 (range 49-79) years. Thirteen (59%) as destination therapy, eight (36%) bridge transplantation (BTT), one an emergency after cardiogenic shock (5%). None BTT heart before dying. Most (n = 13) lived family mean Eastern Cooperative Oncology Group (ECOG) performance status three. between first contact 1.71 years, range 49 days more than 6 years after. Two in-hospital death 10.2 (1-42) days. died 16 (0.7-44) months contact, only on external unit. Based thorough examination case reports, we describe necessity for expertise, ethical communicative issues well available resources this setting.Despite unequivocal recommendations patients, integration these yet not established.