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A Call for Guidance in the Use of Left Ventricular Assist Devices in Older Adults
Author(s) -
Vitale Caroline A.,
Chandekar Rashmi,
Rodgers Phillip E.,
Pagani Francis D.,
Malani Preeti N.
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03740.x
Subject(s) - medicine , ventricular assist device , quality of life (healthcare) , intensive care medicine , heart failure , destination therapy , transplantation , cognition , gerontology , physical medicine and rehabilitation , physical therapy , surgery , cardiology , psychiatry , nursing
Ethics, Public Policy and Medical Economics Left ventricular assist devices ( LVAD s) are approved as “destination therapy” (permanent use without plans for transplantation) in individuals with advanced heart failure who are not candidates for a cardiac transplant; as such, these devices are increasingly being used in older adults. Although LVAD s have been shown to increase quality of life and survival, the associated treatment burdens and complications deserve careful consideration. The current study illustrates myriad clinical challenges that can arise during long‐term mechanical support using an older adult case history. Current data on LVAD use in older adults is reviewed, and a discussion of relevant points to consider before LVAD implantation in older adults, including advance care planning, assessment of gait and cognition, and the potential for substantial caregiver burden, is undertaken.