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Heart Failure Reviews

, 14:21 | Cite as

LVAD destination therapy: applying what we know about psychiatric evaluation and management from cardiac failure and transplant

  • Anne K. Eshelman
  • Shawn Mason
  • Hassan Nemeh
  • Celeste Williams
Article

Abstract

Left ventricular assist devices (LVADs) have evolved into long-term use as destination therapy for those with severe end-stage heart failure due to other medical risks. Success with LVAD depends on adherence to a complicated mechanical regimen, and acceptance of a life that is far from normal. Patients with LVADs share characteristics with other end-stage cardiac failure patients and those waiting for or receiving heart transplants. Understanding the more thoroughly studied issues of psychiatric disorders, adherence, and behavioral correlates of success in heart failure and transplantation may identify feasible strategies for optimizing care of LVAD patients and suggest directions for future research. Depression and distress complicate post-transplant care. Psychiatric morbidity is associated with poor outcomes, including graft rejection, non-adherence, hospitalizations, infection, and death. With a high risk of embolic neurological events, patients’ ability for self-care may be compromised. Psychiatric symptoms are underdiagnosed and undertreated, which may impact overall survival and quality of life.

Keywords

LVAD destination therapy Psychiatric evaluation Heart failure 

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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Anne K. Eshelman
    • 1
  • Shawn Mason
    • 2
  • Hassan Nemeh
    • 3
  • Celeste Williams
    • 4
  1. 1.BioScienceHenry Ford Hospital/CFP6DetroitUSA
  2. 2.PsychologyHenry Ford Health SystemDetroitUSA
  3. 3.Cardiothoracic SurgeryHenry Ford Health System DetroitUSA
  4. 4.CardiologyHenry Ford Health SystemDetroitUSA

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