HFSA: Excuse me, would you care for an LVAD?

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BOSTON—While left ventricular assist devices (LVADs) may be a good destination therapy for heart failure (HF) patients, how do patients feel about receiving one? Researchers from Brigham and Women’s Hospital in Boston found that patients may not be opposed to them, and may actually be keen on receiving a device, Garrick C. Stewart, MD, said during the rapid fire abstracts session Sept. 19 at the 15th annual Heart Failure Society of America (HFSA) scientific meeting.

Patient priorities must be considered, but little is known about the thresholds, concerns and willingness of a patient to accept LVAD therapy. To better understand patient interpretations of LVADs, Stewart and colleagues created a survey to understand patients’ thoughts and knowledge of the devices.

Stewart presented the results of the MedaMACS screening pilot, which enrolled 150 patients who were neither listed for transplant or on inotropes, at the conference. The patients were NYHA Class III/IV, had ejection fractions less than or equal to 30 percent and had two HF hospitalizations in 12 months or one HF hospitalization plus a high-risk condition.

During the survey, Stewart and colleagues asked patients whether or not they would want to be placed with an LVAD.

The study cohort had a mean age of 57 years; 57 percent of whom had HF for more than five years. Sixty-two percent of patients said that they had heard of LVAD devices or knew something about their uses.

The researchers reported that 56 percent of patients said that based on the way they currently felt, they would “definitely or probably” want an LVAD. And, among these patients, 91 percent were classified as being low or intermediate risk. Only 7 percent of patients said they definitely would not want a device.

The majority of these patients who wanted an LVAD said that they would want one if they had less than six months to live. As patients’ disease worsened, enthusiasm for the LVAD increased.

Stewart said that hospitals should begin to “engage patients early about thresholds for considering LVADs,” and said that educating patients about LVAD devices and survival will become increasingly important.