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

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

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