title: Continuous flow left ventricular assist devices: shared care goals of monitoring and treating patients.
abstract: Continuous-flow left ventricular assist devices (CF-LVADs) have been clinically adopted as a long-term standard of care therapy option for patients with end-stage heart failure. For many patients, shared care between the care providers at the implanting center and care providers in the community in which the patient resides is a clinical necessity. The aims of this review are to (1) provide a rationale for the outpatient follow-up exam and surveillance testing used at our center to monitor patients supported by the HeartMate II(®) CF-LVAD (Thoratec Corporation, Pleasanton, CA) and (2) provide the protocol/algorithms we use for blood pressure, driveline exit site, LVAD alarm history, surveillance blood work, and echocardiography monitoring in this patient population. In addition, we define our partnership outpatient follow-up protocol and the "shared care" specific responsibilities we use with referring health care providers to best manage many of our patients.
authors: Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas ; Houston Methodist Hospital, Houston, Texas.
authors: Jerry D
authors: JD
authors: Estep
authors: Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas ; Houston Methodist Hospital, Houston, Texas.
authors: Barry H
authors: BH
authors: Trachtenberg
authors: Houston Methodist Hospital, Houston, Texas.
authors: Laurie P
authors: LP
authors: Loza
authors: Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas ; Houston Methodist Hospital, Houston, Texas.
authors: Brian A
authors: BA
authors: Bruckner
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010347:Patient Care Planning / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D063868:Patient Outcome Assessment; D011379:Prognosis; D013997:Time Factors
keywords: continuous flow LVAD; heart failure; left ventricular assist device; shared care