Quality of life and psychological well-being during and after left ventricular assist device support.
BACKGROUND
Left ventricular assist devices (LVAD) are increasingly being used to treat patients in end-stage heart failure to facilitate survival to cardiac transplant or as a bridge to myocardial recovery. The technical innovation of the LVAD has a significant benefit on the patients' physical functioning. However, within the United Kingdom, there has been no systematic evaluation of the psychological adjustment and quality of life (QoL) of patients currently living with an LVAD, or of the differences in QoL for patients who are either explanted or transplanted.


OBJECTIVE
To assess the differences in QoL and psychological adjustment for current LVAD patients, patients who have been transplanted from an LVAD and patients in whom the device has been explanted.


METHODS
Twenty-two patients involved in an LVAD programme were recruited (18 men and four women; age range 18-60). Eight patients had an LVAD in situ, six patients had the LVAD explanted and eight had undergone transplantation. QoL and psychological functioning were assessed using previously validated measures.


RESULTS
Although there were no significant differences between the three groups, there was a trend for the LVAD patients to have higher levels of anxiety and depression and a lower QoL compared with transplanted or explanted patients.


CONCLUSIONS
For patients with an LVAD in situ, there was a trend for QoL and psychological functioning to be poorer than for transplanted and explanted patients. Larger studies will be needed to confirm these findings, but psychological assessment and interventions to reduce psychological morbidity and improve QoL will be important in these patients, particularly in view of the increasing numbers of LVADs being implanted and the possibility of their use for long-term "destination" therapy.
Wray
Jo
J
Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield NHS Trust, Harefield, Middlesex, UK. j.wray@rbh.nthames.nhs.uk
Hallas
Claire N
CN
Banner
Nicholas R
NR
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D016027:Heart Transplantation / Q000523:psychology; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000523:psychology*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D006113:United Kingdom; D018487:Ventricular Dysfunction, Left / Q000523:psychology* / Q000601:surgery