Staged discharge out of hospital of the Novacor left ventricular assist system (LVAS) recipients.
The mobility afforded by the wearable Novacor LVAS provides the possibility for the recipients to leave the hospital, with undoubted improvements in their quality of life. A staged program for discharging LVAS recipients from the hospital has been set up at the Policlinico San Matteo of Pavia together with the Rehabilitation Center of Montescano and Baxter Novacor Service support, in order to proceed smoothly towards patient's self sufficiency and to minimize any associated risk. The steps are: stay in the hospital ward, discharge to Rehabilitation Center and discharge to home. Several excursions with and without an LVAS team member are encouraged before final discharge to home. Simple criteria of eligibility must be fulfilled to move to the next step. Every move towards a reduced presence of specialized personnel includes an appropriate training of the patient and relatives and a technical checkout of the needed equipment. During the stay at the Rehabilitation Center primarily the physical training and psychological preparation are taken care of by means of tailored programs. When the patient is discharged to home, the check of patient condition is performed weekly at the Rehab Center, bloodwork and technical evaluation is assessed once every two weeks and technical inspections at home twice per year. Complications are reported as in hospital protocol. Control parameters of the LVAS are reported only in case of alarms or abnormal operation. Periodic review of patient training is performed during the check visits, mostly focused on how to address emergency situations. The hospital is responsible for providing one LVAS operator available on call (all hours). Up to date, 11 patients received an implant of LVAS, 9 of them with the wearable system. All of these 9 patients made excursions out of the hospital and 4 patients have successfully undergone the staged program, showing a satisfactory general condition and restoration to social life.
Viganó
M
M
Department of Heart Surgery, IRCCS Policlinico S Matteo, Universita' di Pavia, Italy.
Scuri
S
S
Cobelli
F
F
Opasich
C
C
Pagani
F M
FM
Minzioni
G
G
Martinelli
L
L
Tavazi
L
L
Viganó
M
M
D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010351:Patient Discharge; D011788:Quality of Life