Protocol for releasing Novacor left ventricular assist system patients out-of-hospital.
Between September 1984 and April 1995, the Novacor left ventricular assist system (LVAS) has provided more than 13,000 days of mechanical circulatory support to cardiac transplant candidates in the United States and Europe. The duration of support of these 312 patients has ranged between 1 and 370 days, with an average support of 40 days, including use of the console based system and the wearable system. Of this group, 21% have been supported for more than 60 days, with an average support of 118 days. We have seen that patients who have been supported for more than 30 days have recovered from the effects of LVAS implant surgery and have shown a potential for rehabilitation from morbid congestive heart failure. Few changes to the pump settings or the medical orders have been needed after the third postoperative week. The reliability of the LVAS and the degree to which patients can be rehabilitated suggest that restricting patients to a hospital environment is unnecessary. In addition, the increasing wait for a donor heart, the quality of life that can be achieved, and the high cost of inpatient care make it desirable to discharge patients from the hospital and allow them to await a donor heart in a more home-like setting.
Pristas
J M
JM
Artificial Heart Program, University of Pittsburgh Medical Center, PA 15213-2582, USA.
Winowich
S
S
Nastala
C J
CJ
Gifford
J
J
Conner
E A
EA
Borovetz
H S
HS
Griffith
B P
BP
Portner
P M
PM
Kormos
R L
RL
D000553:Ambulatory Care / Q000592:standards; D002985:Clinical Protocols; D004630:Emergencies; D005060:Europe; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006798:Housing; D006801:Humans; D010351:Patient Discharge / Q000592:standards*; D010353:Patient Education as Topic; D011788:Quality of Life; D013997:Time Factors; D014186:Transportation; D014481:United States