Defining LVAD Success: A Nationwide Survey of LVAD Program Team Members.
Cogswell R, Rafei AE, Cowger J, Joseph S, Schultz J, Estep J, John R, and Eckman P. Defining LVAD Success: A Nationwide Survey of LVAD Program Team Members. Journal of Heart and Lung Transplantation 2020; 39(4):S180-S181.
J Heart Lung Transplant
Purpose: The purpose of this study was to determine how LVAD success is defined by LVAD team members across the United States. Methods: An online, anonymous survey was shared with 32 LVAD programs across the country. Six case vignettes were provided: 1) young active drug user 2) demanding patient 3) medically complicated patient 4) socially isolated patient 5) patient with financial barriers, and 6) a non-compliant patient. Individual respondents were asked: 1) Would your program implant a patient like this? 2) Would you vote to implant a patient like this? 3) Do you think this LVAD will be successful? Clinical follow-up was provided and respondents were asked: 4) Was this LVAD successful? Results: A total of 88 survey responses were completed including 22 (24%) LVAD advance practice providers, 29 (32%) CHF cardiologists, 28 (31%) LVAD coordinators, 8 (9%) surgeons, and 3 social workers (3%). The respondents had an average of 6.5 years of experience in advanced heart failure. Results are shown in the Table. We found frequent differences between individual opinions and program decisions. Responses were also significantly different when stratified by professional role. In addition, respondents often supported implant, even if they predicted it was unlikely to be successful. Finally, the definition of LVAD success varied by years of experience and professional role. Conclusion: This national survey quantifies the lack of consensus around the definition of LVAD success. Society guidelines regarding patient selection will continue to face challenges due to lack of consensus in the community.