ABSTRACT
Mechanical support technology continues to evolve. Ongoing research has led to more efficient devices allowing for discharge to outpatient or home settings. From December of 1991 to July 31, 2000 the Cleveland Clinic Foundation has placed 240 mechanical support devices. These include 173 HeartMate devices of the Pneumatic or Vented Electric models, 56 Novacors, and 11 Thoratecs. Patients placed on mechanical support potentially proceed through six phases of support. This begins with the evaluation process and progresses through the perioperative phase, the intensive care phase, the regular nursing floor phase, discharge, and transplantation. We have developed a specialized team to care for this patient population. As a result, the nursing and psychosocial care of patients on mechanical support has advanced over years of experience. We have been able to identify specific nursing and psychosocial issues that develop through the phases of support. Becoming aware of these issues will assist in a successful outcome for the patient.
Subject(s)
Heart-Assist Devices/psychology , Critical Care , Heart Transplantation , Humans , Patient Care Team , Postoperative CareABSTRACT
Partial left ventriculectomy (PLV) surgery has gained significant attention worldwide as a possible alternative to heart transplantation or as a therapy to treat heart failure. This procedure offers an attractive choice to patients and physicians because of the lack of need for immunosuppressive medications and a decrease in the risk of rejection associated with transplantation. PLV surgery is currently under investigation in several centers worldwide, but long-term outcomes have yet to be definitively evaluated. The Cleveland Clinic Foundation began performing PLV surgery in May 1996. Since that time, 57 patients have received the procedure with actuarial survival of 82% at 1 year. The purpose of this article is to highlight the clinical management of the postoperative PLV patient.
