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Cameli M, Pastore MC, Mandoli GE, Landra F, Lisi M, Cavigli L, D'Ascenzi F, Focardi M, Carrucola C, Dokollari A, Bisleri G, Tsioulpas C, Bernazzali S, Maccherini M, Valente S. A multidisciplinary approach for the emergency care of patients with left ventricular assist devices: A practical guide. Front Cardiovasc Med 2022; 9:923544. [PMID: 36072858 PMCID: PMC9441753 DOI: 10.3389/fcvm.2022.923544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/21/2022] [Indexed: 12/03/2022] Open
Abstract
The use of a left ventricular assist device (LVAD) as a bridge-to-transplantation or destination therapy to support cardiac function in patients with end-stage heart failure (HF) is increasing in all developed countries. However, the expertise needed to implant and manage patients referred for LVAD treatment is limited to a few reference centers, which are often located far from the patient's home. Although patients undergoing LVAD implantation should be permanently referred to the LVAD center for the management and follow-up of the device also after implantation, they would refer to the local healthcare service for routine assistance and urgent health issues related to the device or generic devices. Therefore, every clinician, from a bigger to a smaller center, should be prepared to manage LVAD carriers and the possible risks associated with LVAD management. Particularly, emergency treatment of patients with LVAD differs slightly from conventional emergency protocols and requires specific knowledge and a multidisciplinary approach to avoid ineffective treatment or dangerous consequences. This review aims to provide a standard protocol for managing emergency and urgency in patients with LVAD, elucidating the role of each healthcare professional and emphasizing the importance of collaboration between the emergency department, in-hospital ward, and LVAD reference center, as well as algorithms designed to ensure timely, adequate, and effective treatment to patients with LVAD.
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Affiliation(s)
- Matteo Cameli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Maria Concetta Pastore
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- *Correspondence: Maria Concetta Pastore
| | - Giulia Elena Mandoli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Federico Landra
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Matteo Lisi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Division of Cardiology, Department of Cardiovascular Diseases -AUSL Romagna, Ospedale S. Maria delle Croci, Ravenna, Italy
| | - Luna Cavigli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Flavio D'Ascenzi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marta Focardi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Chiara Carrucola
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Aleksander Dokollari
- Department of Cardiac Surgery, Cardiac Surgery, St. Michael Hospital, Toronto, ON, Canada
| | - Gianluigi Bisleri
- Department of Cardiac Surgery, Cardiac Surgery, St. Michael Hospital, Toronto, ON, Canada
| | - Charilaos Tsioulpas
- Department of Cardiac Surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Sonia Bernazzali
- Department of Cardiac Surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Massimo Maccherini
- Department of Cardiac Surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Serafina Valente
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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