Outpatient Care for Implantable Left Ventricular Assist Device Patients

Yorihiko Matsumoto, Tomoyuki Fujita, Satsuki Fukushima, Osamu Seguchi, Masanobu Yanase, Yumiko Hori, Takako Nakaya, Norihide Fukushima, Junjirou Kobayashi

Research output: Contribution to journalArticlepeer-review

Abstract

From 2005, 124 patients have received implantable left ventricular assist device (iVAD) in our institute, including HeartMate II (84), EVAHEART (17), Jarvik2000 (13), DuraHeart (9), HVAD (1). At February 2018, 60 patients were waiting for heart transplant with iVAD support. Multi-specialist team consisted of clinical engineer, VAD management specialist, nurse, transplant coordinator for recipient and physicians provide patients care. Thirty one percents returned to their social activity after iVAD implantation. 73% patients required rehospitalization for more than 1 time. Overall frequency of rehospitalization was 1.43 events per patient-year. Driveline infection was the most frequent reason and tended to repeat, accounted for 41% of overall rehospitalization. To reduce skin trouble around the driveline exit site causing driveline infection, we made a skin care outpatient clinic, cooperating with a certified nurse in wound, ostomy, and continence nursing (WOC). Besides, we utilize smartphones for remote advising system for patients to facilitate early diagnosis and precise care for driveline infection. A self-anticoagulation management device( Coag-check XS personal) enable us to give adequate anticoagulation therapy and to minimize bleeding and thromboembolic event. Additionally, establishment of psychosocial care promote patient's recovery of social status. With those strategies in outpatient care, we are trying to achieve successful quality of life of iVAD patients.

Original languageEnglish
Pages (from-to)532-537
Number of pages6
JournalKyobu geka. The Japanese journal of thoracic surgery
Volume71
Issue number7
Publication statusPublished - 01-07-2018

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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