Forest et al reviewed their experience with the use of ventricular assist devices (VAD). Their data can help to advice a patient prior to informed consent. The authors are from Montefiore Medical Center and Albert Einstein College of Medicine in New York City.
Reasons for insertion of VAD:
(1) bridge to transplant
(2) destination therapy
(3) left ventricular assistance pending functional recovery
About 80% had at least one readmission, with most having 1-3.
Most readmissions were relatively short.
Most were urgent with few life-threatening.
The mortality rate was 14%.
Over 90% of days after insertion were out of hospital.
Most common reasons for readmission:
(1) GI bleeding (14% of readmissions)
(2) infection
(3) device alarm
Less common reasons:
(1) abdominal pain, nausea or vomiting
(2) volume overload
(3) cardiac arrhythmia
(4) stroke or TIA
(5) syncope or near syncope
(6) renal failure
(7) non-GI bleeding
Patients who were readmitted tended to be older. No clear predictors for 30-day readmission were identified.
