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The Rehabilitation of Patients With Advanced Heart Failure After Left Ventricular Assist Device Placement: A Narrative Review
Author(s) -
Eickmeyer Sarah M.,
Barker Kim D.,
Sayyad Anjum,
Rydberg Leslie
Publication year - 2019
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2018.05.027
Subject(s) - rehabilitation , medicine , heart failure , ventricular assist device , quality of life (healthcare) , destination therapy , intensive care medicine , stroke (engine) , physical therapy , heart transplantation , transplantation , physical medicine and rehabilitation , cardiology , surgery , nursing , mechanical engineering , engineering
Because more patients with advanced heart failure are receiving a left ventricular assist device (LVAD) as destination therapy or a bridge to transplantation, there is increasing attention on functional outcomes and quality of life after LVAD implantation. Rehabilitation providers in the acute inpatient rehabilitation setting increasingly will treat patients with an LVAD and should understand the exercise physiology, medical management, rehabilitation considerations, and outcomes after rehabilitation for patients with an LVAD. The purpose of this article is to provide the physiatrist with a comprehensive understanding of the rehabilitation of patients with advanced heart failure and LVAD implantation. Changes in relevant organ system physiology and exercise physiology after LVAD are summarized. Safety of rehabilitation and program considerations for acute inpatient rehabilitation are reviewed. Recommendations for medical management and prevention of secondary complications seen in patients with an LVAD are outlined. A discussion of outcomes after acute inpatient rehabilitation, the dual diagnosis of stroke and LVAD placement, and long‐term cognitive, functional, and quality‐of‐life outcomes after LVAD placement is presented.