- 1 A Historical Perspective on the Development of Mechanical Circulatory Support Devices
- 2 Indications for Mechanical Circulatory Support
- 3 Frailty: Assessment and Associations with Outcomes
- 4 Palliative Care in Mechanical Circulatory Support
- 5 Psychosocial Assessment of Patients Considered for Mechanical Circulatory Support
- 6 Left Ventricular Assist Device Backup for Conventional Surgery
- 7 Preoperative Strategies for Optimizing Mechanical Circulatory Support
- 8 Mechanical Circulatory Support in Patients with Pulmonary Hypertension
- 9 Selecting Children for Mechanical Circulatory Support
- 10 Device Selection for Short- and Long-Term Mechanical Circulatory Support
- 11 The HeartMate II™ Continuous-Flow Left Ventricular Assist System
- 12 The Abbott HeartMate 3™ Left Ventricular Assist System
- 13 The HeartWare<sup>™</sup> HVAD<sup>™</sup> Left Ventricular Assist Device
- 14 The Medtronic Miniature Left Ventricular Assist Device (MVAD)<sup>™</sup> System
- 15 The ReliantHeart aVAD<sup>©</sup>
- 16 The Syncardia Total Artificial Heart
- 17 Counterpulsation Circulatory Assist Devices
- 18 Abiomed Impella Platform
- 19 The Tandem: Life System
- 20 The Abbott CentriMag™ Acute Circulatory Support System and the HeartMate Percutaneous Heart Pump™
- 21 Extracorporeal Membrane Oxygenation
- 22 The Berlin Heart Ventricular Assist Devices
- 23 EVAHEART<sup>®</sup> 2 Left Ventricular Assist Device System
- 24 Anesthesia
- 25 Perfusion Considerations
- 26 Echocardiography in Left Ventricular Assist Device Recipients
- 27 Implantation of Continuous-Flow Left Ventricular Assist Devices via Sternotomy Technical Considerations
- 28 The Less-Invasive (Lateral) Approach to Left Ventricular Device Implantation
- 29 Concomitant Cardiac Valve Procedures with Circulatory Support Device Implantation
- 30 Providing Mechanical Support to Children Size and Anatomical Considerations
- 31 Postoperative Management after Assist Device Implantation
- 32 Anticoagulation Strategies for Patients on Mechanical Circulation Support
- 33 Acquired von Willebrand Syndrome with Mechanical Circulatory Support
- 34 Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices
- 35 Pump Thrombosis
- 36 Infectious Complications of Mechanical Circulatory Support
- 37 Cerebral Blood Flow and Stroke in Patients with Left Ventricular Assist Devices
- 38 Right Heart Dysfunction
- 39 Renal Failure and Mechanical Circulatory Support Devices
- 40 Arrhythmia/Ventricular Tachycardia Ablation
- 41 Aortic Regurgitation in Patients with Left Ventricular Assist Devices
- 42 Modalities of Left Ventricular Assist Device Optimization
- 43 The CardioMEMS Heart Failure Monitoring System
- 44 Mechanical Circulatory Support as a Bridge to Recovery
- 45 Cardiac and Physical Rehabilitation
- 46 The VAD Coordinator Roles and Responsibilities in Caring for Patients with Ventricular Assist Devices
(p. 23) Palliative Care in Mechanical Circulatory Support
- Chapter:
- (p. 23) Palliative Care in Mechanical Circulatory Support
- Author(s):
Regina M. Mackey
and Jacob J. Strand
- DOI:
- 10.1093/med/9780190909291.003.0004
Palliative care teams are increasingly involved in the care of patients with advanced circulatory failure and play an important role in the care of patients undergoing implantation of left ventricular assist devices. Palliative care teams focus on symptom management, caregiver support, and robust advance care planning for patients in the pre-implantation and post-implantation phase of care. Preoperative envolvement of Palliative care is effective in helping the patient articulate his/her goals and reason for pursuing surgical intervention as well as declaring just how committed the patient is to long term medical care should various types of complications occur in the perioperative period. This provides comfort to the family when a difficult decision has to be made at a time when the patient can’t take an active part in making that decision. Effective Palliative care teams are present to celebrate the victories as well as the failures in patient care.
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- 1 A Historical Perspective on the Development of Mechanical Circulatory Support Devices
- 2 Indications for Mechanical Circulatory Support
- 3 Frailty: Assessment and Associations with Outcomes
- 4 Palliative Care in Mechanical Circulatory Support
- 5 Psychosocial Assessment of Patients Considered for Mechanical Circulatory Support
- 6 Left Ventricular Assist Device Backup for Conventional Surgery
- 7 Preoperative Strategies for Optimizing Mechanical Circulatory Support
- 8 Mechanical Circulatory Support in Patients with Pulmonary Hypertension
- 9 Selecting Children for Mechanical Circulatory Support
- 10 Device Selection for Short- and Long-Term Mechanical Circulatory Support
- 11 The HeartMate II™ Continuous-Flow Left Ventricular Assist System
- 12 The Abbott HeartMate 3™ Left Ventricular Assist System
- 13 The HeartWare<sup>™</sup> HVAD<sup>™</sup> Left Ventricular Assist Device
- 14 The Medtronic Miniature Left Ventricular Assist Device (MVAD)<sup>™</sup> System
- 15 The ReliantHeart aVAD<sup>©</sup>
- 16 The Syncardia Total Artificial Heart
- 17 Counterpulsation Circulatory Assist Devices
- 18 Abiomed Impella Platform
- 19 The Tandem: Life System
- 20 The Abbott CentriMag™ Acute Circulatory Support System and the HeartMate Percutaneous Heart Pump™
- 21 Extracorporeal Membrane Oxygenation
- 22 The Berlin Heart Ventricular Assist Devices
- 23 EVAHEART<sup>®</sup> 2 Left Ventricular Assist Device System
- 24 Anesthesia
- 25 Perfusion Considerations
- 26 Echocardiography in Left Ventricular Assist Device Recipients
- 27 Implantation of Continuous-Flow Left Ventricular Assist Devices via Sternotomy Technical Considerations
- 28 The Less-Invasive (Lateral) Approach to Left Ventricular Device Implantation
- 29 Concomitant Cardiac Valve Procedures with Circulatory Support Device Implantation
- 30 Providing Mechanical Support to Children Size and Anatomical Considerations
- 31 Postoperative Management after Assist Device Implantation
- 32 Anticoagulation Strategies for Patients on Mechanical Circulation Support
- 33 Acquired von Willebrand Syndrome with Mechanical Circulatory Support
- 34 Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices
- 35 Pump Thrombosis
- 36 Infectious Complications of Mechanical Circulatory Support
- 37 Cerebral Blood Flow and Stroke in Patients with Left Ventricular Assist Devices
- 38 Right Heart Dysfunction
- 39 Renal Failure and Mechanical Circulatory Support Devices
- 40 Arrhythmia/Ventricular Tachycardia Ablation
- 41 Aortic Regurgitation in Patients with Left Ventricular Assist Devices
- 42 Modalities of Left Ventricular Assist Device Optimization
- 43 The CardioMEMS Heart Failure Monitoring System
- 44 Mechanical Circulatory Support as a Bridge to Recovery
- 45 Cardiac and Physical Rehabilitation
- 46 The VAD Coordinator Roles and Responsibilities in Caring for Patients with Ventricular Assist Devices