Navigation Links
ISHLT issues new guidelines for care of mechanical circulatory support device patients
Date:1/9/2013

New York, NY, January 10, 2013 Mechanical circulatory support (MCS) is a rapidly growing technology used to treat advanced heart failure. Thousands of patients worldwide have now undergone implantation of long- term MCS devices (MCSDs) that can enable them to return home and resume a normal lifestyle. The International Society for Heart and Lung Transplantation (ISHLT) convened an international panel of experts in all aspects of MCS care, which has developed practice guidelines to provide a common framework for the care and treatment of MCS patients. The Executive Summary of these guidelines is published in the February issue of The Journal of Heart and Lung Transplantation and is freely available at www.jhltonline.org.

Chaired by David Feldman, MD, PhD, Minneapolis Heart Institute, and the Georgia Institute of Technology and Morehouse School of Medicine; Salpy V Pamboukian, MD, MSPH, University of Alabama at Birmingham; and Jeffrey J. Teuteberg, MD, University of Pittsburgh, the guidelines were developed by consensus by a team of 38 writers and reviewers including cardiologists, cardiac surgeons, MCS coordinators, and other members of the global multidisciplinary team.

"Because MCS is an evolving field, device availability varies from center to center. We therefore aim to address general issues of long-term use and not to focus on nuances of individual devices," explain the co-chairs. "Short-term success with MCS therapy largely depends on patient selection, surgical technique, and post-operative management. Long-term success depends on physician and patient engagement in excellent care of their device and personal health," they say.

The document results from the work of five Task Forces:

Task Force 1 addresses the important issue of patient selection and risk management prior to permanent pump implantation. It makes recommendations about how candidates for MCSD implantation should be evaluated and classified beforehand, including clinical assessment of heart failure etiology and anatomic considerations, as well as specific recommendations for candidates with existing disease such as diabetes, cancer, tobacco use, and obesity. Medical and psychosocial evaluation, assessment of operative risk, and ethical dilemmas are also discussed.

Task Force 2 discusses the mechanisms that are important for patient optimization before device implantation and makes recommendations for multidisciplinary care, education, and psychosocial support. This section covers the management of cardiac and non-cardiac risk factors, optimizing patients with relative contraindications, and informed consent and ethical issues as a continuum from Task Force 1. MCS patients once consented are members of their care team before implantation.

Task Force 3 discusses the intra-operative considerations and immediate post-operative care in the intensive care unit (ICU). This section provides recommendations for anesthesia, implantation techniques, explantation techniques, complex anatomic considerations, and early post- operative management in the ICU.

Task Force 4 addresses inpatient management during the post-operative phase, once the patient is out of the ICU and during readmission to the hospital. This section includes recommendations about psychosocial support and suitability for discharge to home and common reasons for hospital readmission and approaches to their management.

Task Force 5 discusses the long-term outpatient care of the MCS patient. The Task Force recommends that after returning home, patients should be managed by a multidisciplinary team that includes cardiovascular surgeons, advanced heart failure cardiologists, and specialized MCS coordinators. It highlights the importance of assessing the patient's social network and/or caregivers, recommending that the patient and their caregivers should be trained to recognize MCSD alarms and troubleshoot emergencies using both written materials and visual demonstrations and that their emergency response skills should be tested before being discharged from hospital.

"We hope these guidelines provide an impetus for organized dissemination of best practices from various centers with excellent outcomes into the literature to further the field of MCS," conclude the co-chairs.


'/>"/>

Contact: Linda Gruner
jhltmedia@elsevier.com
212-633-3923
Elsevier Health Sciences
Source:Eurekalert

Related medicine news :

1. UCSF chancellor issues call-to-arms to patient advocates
2. Radiologists rank themselves as less than competent on health policy issues
3. Genetic abnormalities in benign or malignant tissues predict relapse of prostate cancer
4. FDA Issues Multiple Sclerosis Drug Alert
5. Quality of care, other issues may cause worse results in black prostate cancer surgery patients
6. U.S. Task Force Issues Blood Pressure Guidelines
7. Internists in Washington to discuss patient and professional issues in meetings on Capitol Hill
8. Cheaper drug could lead to serious eye issues
9. Insulite Labs announces the launch of the PCOS Inspiration Hour, a one hour virtual gathering place for women with PCOS and other women’s health issues to come together.
10. LawyersandSettlements.com Issues Report on Prostate Health Claim Lawsuits and Propecia Side Effect Litigation
11. What Men Should Know About Veins: Varicose Veins and Venous Disease are Real Medical Issues
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... ... May 04, 2016 , ... ... 2016, a powerful cellular therapy software application that helps blood and marrow transplant ... , Since Transtem’s initial launch, Mediware has continued to enhance core application features. ...
(Date:5/4/2016)... ... May 04, 2016 , ... International Conference on Obesity and ... 2016 at Las Vegas. It aims to bring together academicians, scientists, dietitians, surgeons, ... organizations across the globe; making the conference a perfect platform to share experience ...
(Date:5/3/2016)... ... May 04, 2016 , ... The National Association of Professional Women (NAPW) ... of the Year Circle. She is recognized with this prestigious distinction for leadership in ... than 850,000 members and over 200 operating Local Chapters. , “I’m pleased to welcome ...
(Date:5/3/2016)... ... , ... Sue Desmond-Hellmann, chief executive officer of the Bill & Melinda Gates ... possibility in her keynote address at Georgia State University’s spring commencement on ... rich experience as a scientist, physician and executive, Desmond-Hellmann leads the Gates Foundation’s efforts ...
(Date:5/3/2016)... Baltimore, Md. (PRWEB) , ... May 03, 2016 , ... ... devastating consequences of inappropriate or excessive levels of alcohol use. Alcohol and its ... fetal alcohol spectrum disorders to the susceptibility to strokes in those 65 years and ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... OSWEGO, Ore. , May 3, 2016 /PRNewswire/ ... endovascular medical technology, today announced Food and Drug ... cardiac resynchronization defibrillator that provides heart failure patients ... scans. Iperia devices also have remote monitoring with ... that adapts the heart rate in response to ...
(Date:5/3/2016)... , May 3, 2016   BIOTRONIK ... of extending care beyond the implant at the Heart ... 4-7 in San Francisco . ... delivering the highest quality of patient care and satisfaction ... cared for each and every tomorrow," said Marlou ...
(Date:5/3/2016)... 2016 Pharmaceutical giant Johnson & ... a woman who says its talc-based powder products caused ... Ristesund $5 million in compensatory damages and $50 ... http://photos.prnewswire.com/prnh/20160330/349511LOGO ) , This is the ... In February, the same court awarded $72 million to ...
Breaking Medicine Technology: