Thomas Schlöglhofer1, Desiree Robson2, Jayne Bancroft3, Gro Sørensen4, Friedrich Kaufmann5, Leslie Sweet6, Neil Wrightson7. 1. Center for Medical Physics and Biomedical Engineering, Department of Cardiac Surgery, Medical University of Vienna, Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna - Austria. 2. Mechanical Circulatory Support Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney - Australia. 3. Advanced Heart Failure and Cardiac Transplant Unit, Prince Charles Hospital - Australia. 4. Cardiothoracic Department, Oslo University Hospital, Oslo - Norway. 5. Department of Cardiothoracic and Vascular Surgery, German Heart Institute, Berlin - Germany. 6. HeartWare Inc., Framingham, MA - USA. 7. Cardiothoracic Surgery, Freeman Hospital, Newcastle upon Tyne - UK.
Abstract
PURPOSE: While the HeartWare® Ventricular Assist System (HVAS) is a successful therapy for end-stage heart failure, outpatient management methods can vary significantly and require further investigation. METHODS: A survey to assess the long-term HVAS patient management and monitoring strategies was completed by 36 international heart centers that currently have over 1,450 patients on VAD support either at home or in the hospital. Multiple choice questions examined VAD program characteristics, anticoagulation management, driveline exit-site dressing and showering recommendations, blood pressure and pump parameter monitoring, and patient discharge protocols. RESULTS: Outpatient international normalized ratio (INR) was most frequently measured every 3-4 days (28.6%), and the most frequent schedule for changing driveline exit site dressings was 3 times per week (30.6%). Only 25.7% of centers required their patients to measure blood pressure at home. A subgroup analysis was performed to assess the influence of center experience and larger centers generally had more frequent monitoring compared to smaller centers. CONCLUSIONS: This survey showed specific differences in outpatient management strategies that were previously unreported. However, further studies with correlations to patient outcomes are necessary to determine optimal patient management recommendations.
PURPOSE: While the HeartWare® Ventricular Assist System (HVAS) is a successful therapy for end-stage heart failure, outpatient management methods can vary significantly and require further investigation. METHODS: A survey to assess the long-term HVAS patient management and monitoring strategies was completed by 36 international heart centers that currently have over 1,450 patients on VAD support either at home or in the hospital. Multiple choice questions examined VAD program characteristics, anticoagulation management, driveline exit-site dressing and showering recommendations, blood pressure and pump parameter monitoring, and patient discharge protocols. RESULTS:Outpatient international normalized ratio (INR) was most frequently measured every 3-4 days (28.6%), and the most frequent schedule for changing driveline exit site dressings was 3 times per week (30.6%). Only 25.7% of centers required their patients to measure blood pressure at home. A subgroup analysis was performed to assess the influence of center experience and larger centers generally had more frequent monitoring compared to smaller centers. CONCLUSIONS: This survey showed specific differences in outpatient management strategies that were previously unreported. However, further studies with correlations to patient outcomes are necessary to determine optimal patient management recommendations.
Authors: Francesco Moscato; Christoph Gross; Martin Maw; Thomas Schlöglhofer; Marcus Granegger; Daniel Zimpfer; Heinrich Schima Journal: Ann Cardiothorac Surg Date: 2021-03
Authors: Martin Maw; Thomas Schlöglhofer; Christiane Marko; Philipp Aigner; Christoph Gross; Gregor Widhalm; Anne-Kristin Schaefer; Michael Schima; Franziska Wittmann; Dominik Wiedemann; Francesco Moscato; D'Anne Kudlik; Robert Stadler; Daniel Zimpfer; Heinrich Schima Journal: Front Cardiovasc Med Date: 2022-04-25
Authors: Thomas Schlöglhofer; Johann Horvat; Francesco Moscato; Zeno Hartner; Georg Necid; Harald Schwingenschlögl; Julia Riebandt; Kamen Dimitrov; Philipp Angleitner; Dominik Wiedemann; Günther Laufer; Daniel Zimpfer; Heinrich Schima Journal: Artif Organs Date: 2018-05-25 Impact factor: 3.094
Authors: Christoph Gross; Kamen Dimitrov; Julia Riebandt; Dominik Wiedemann; Günther Laufer; Heinrich Schima; Francesco Moscato; Michael C Brown; Abhijit Kadrolkar; Robert W Stadler; Daniel Zimpfer; Thomas Schlöglhofer Journal: Life (Basel) Date: 2022-04-09
Authors: Thomas Schlöglhofer; Peter Michalovics; Julia Riebandt; Philipp Angleitner; Martin Stoiber; Günther Laufer; Heinrich Schima; Dominik Wiedemann; Daniel Zimpfer; Francesco Moscato Journal: Artif Organs Date: 2020-11-28 Impact factor: 3.094