3 Experience of LVAD as destination therapy at ramathibodi hospital, bangkok

Abstract

Setting up a new left ventricular assist device (LVAD) centre in a low-income country is challenging. Here we present our first case of long-term LVAD as destination therapy. The case illustrated the team effort and importance of the Heart Failure Team (heart failure cardiologists, cardiothoracic surgeons and VAD coordinators), nursing services, hospital administrators and other supportive services (nutrition, social services, physical/rehabilitation services, and finance and data management). In brief, this was a case of a 74-year-old gentleman who had suffered from ischaemic cardiomyopathy (LVEF 22%) and had been hospitalised more than twice in the preceding six months due to decompensated heart failure (New York Heart Association functional class IV). He subsequently underwent HeartMate3 implantation successfully. This case demonstrates the process of patient selection, pre-operative and post-operative management as well as long-term follow-up of LVAD patients.