title: What the Psychiatrist Needs to Know About Ventricular Assist Devices: A Comprehensive Review.
abstract: The number of patients with end-stage heart failure using mechanical circulatory support has dramatically increased over the past decade. Left ventricular assist devices, the most common type of mechanical circulatory support, can be used as a bridge to transplant, destination therapy, and as a bridge to recovery. As this patient population continues to grow, consultation-liaison psychiatrists will become increasingly involved in their care. A thorough biopsychosocial assessment is required to ensure adequate recognition and management of medical, psychiatric, social, and ethical challenges posed by this population.
  
  
  
  We performed a literature review to identify key issues relevant to the practice of consultation-liaison psychiatrists.
  
  
  
  General functioning of left ventricular assist devices, device types, system components, life with a left ventricular assist device, preoperative evaluation, treatment of psychiatric comorbidities, and end-of-life decision-making are discussed.
  
  
  
  Consultation-liaison psychiatrists need to be familiar with the high prevalence of psychopathology in patients implanted with left ventricular assist devices. A detailed biopsychosocial formulation is required to adequately identify and, if possible, resolve a myriad of medical, psychiatric, social, and ethical challenges presented by this population. Future efforts should accurately identify and report specific psychiatric disorders and adverse events within this cohort.
authors.affiliation: Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, OH.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Caro
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Rosenthal
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH.
authors.forename: Kay
authors.initials: K
authors.lastname: Kendall
authors.affiliation: Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, OH.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Pozuelo
authors.affiliation: Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, OH. Electronic address: margofunk@gmail.com.
authors.forename: Margo C
authors.initials: MC
authors.lastname: Funk
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D001334:Automobile Driving; D001828:Body Image; D015897:Comorbidity; D003657:Decision Making; D003693:Delirium / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D006333:Heart Failure / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D011300:Preoperative Care; D011570:Psychiatry; D012017:Referral and Consultation; D012648:Self Care; D013727:Terminal Care
keywords: heart failure; mechanical circulatory; psychiatry; psychopharmacology; psychosocial; support; ventricular assist device