LVAD Clinic: Outpatient Monitoring and Causes for Readmission

Left ventricular assist devices (LVADs) have been shown to improve functional status and quality of life and prolong survival when used for management of patients with endstage heart failure (HF) for both short-term and long-term circulatory support. This chapter focuses on practical outpatient management of implanted mechanical circulatory support with the goal of minimizing complications and supporting the LVAD patient to fully engage in life without symptoms of HF. In the current era, >95% of implants are continuous flow devices and so it focuses on management of patients with continuous flow devices. Cardiac auscultation remains an important component of routine clinical evaluation in the LVAD patient. Patients with LVADs are at high risk for ventricular tachyarrhythmias which are associated with an increased risk of mortality. GI bleeding is one of the most common complications in patients with cf-LVADs and occurs in approximately one-third of patients.