szyjarek

Hi, I work in clinic witch implants 10 lvad a year. We have background in mechanical circulatory support from years of use pulsatile pumps and intensive ecmo program. We din not have special trainig and preparation for lvad implantation. Of course company with produce pumps organized as many trainings and this was very useful. I m vad coordinator and I take care of patient during his stay in hospital and after discharge. In hospital after implantation patient needs to by covered by intensive care team. In my opinion patient with pump is same like others after cardiac implantation but we need to remember how support system change his circulatory system. HeartWare and HeartMate 2/3 systems are sensitive for pre and afterload. So we must create field to proper function of pump but our priority is patient condition. We can expect low flow alarms as a effect of hypovolemic or high resistance. Important is function of right ventricle. It's function will have influence for support and function of LV. If we stabilize patient from circulatory point of view we need to care also of his anticoagulation therapy, driveline wound etc. We need to educate him in all aspects of system and self-care. To improve his care and make our job easier we equipped them with INR control devices to measurement everyday effect of anticoagulants. We have also system for monitoring patient after discharge to home. They send as information about pump functions and parameters and also pressure , plus, weight, temperature and coagulation therapy. We created with group of our patient association with help exchange information about therapy and also as a effect of initiative of patient we created special information card. Regards, Jaroslaw Szymanski