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April 2012, Volume 42 Number 4 , p 47 - 50


  • Charles A. Rowland MSN, CRNP


A GROWING NUMBER of patients with advanced heart failure are candidates for an implanted left ventricular assist device (LVAD) to help the heart pump blood from the left ventricle through the body.1 Patients with LVADs typically fall into three categories: * bridge-to-transplant (temporary support for patients awaiting cardiac transplantation) * bridge-to-recovery (temporary therapy that can be discontinued when the patient's native heart recovers from an acute insult such as from viral myocarditis) * destination therapy (permanent mechanical assistance for patients ineligible for transplantation, living out the remainder of their life on the LVAD).2Based on the Interagency Registry for Mechanically Assisted Circulatory Support, from June 2006 to March 2009, 1,092 patients received LVAD implants.3Whether the device is completely implanted, as with continuous-flow pumps, or resides just outside the body (paracorporeal pulsatile pumps), technology has allowed for the portability of the external system controller and power source. Due to this portability, stable patients can often travel outside of their local communities if they're accompanied by a family member or friend who's been trained to manage the device.As the number of patients with LVADs increases, the potential that they will require healthcare at community hospitals or urgent care centers is on the rise. Therefore, even if your facility doesn't implant LVADs, you may have to provide nursing care to patients who have one.Few patients who receive ventricular assist devices for right ventricular failure or devices for biventricular failure qualify for discharge and outpatient care. Consequently, this article will focus on continuous-flow (nonpulsatile) LVADs, including how they work and how to care for patients with the device.An LVAD is implanted when certain criteria are met (see When an LVAD is needed). Pulsatile devices are hampered by device size, limiting patient selection. The continuous-flow device offers

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