21 Surgical care and perioperative nursing management of LVADs

The perioperative management of patients with a left ventricular assist device (LVAD) presents a whole set of challenges to the nurses at the bedside and outpatient settings.1 Despite the remarkable advancements in technology, the care of patients following LVAD implant remains complex for the multidisciplinary healthcare team. This presentation provides a brief overview of the currently used durable LVAD designs worldwide. These include axial (HeartMate IITM) and magnetic flow levitation (HeartMate 3TM and HeartWare HVAD®) LVADs.2 Discussion of the nursing management of patients post-LVAD implant in the critical care, progressive care, and in the outpatient care settings will be approached at conceptual level. This approach will equip the participant with a ‘thinking framework’ guiding his/her actions in caring for LVAD patients. Salient nursing actions include early detection and management of post-surgical complications, device-related complications, heart failure symptom exacerbations, infection, among others. The nurse’s role in helping patients attain an optimum level of functioning post-implantation during hospitalisation and the impact of the nurse in supporting patients (and caregivers) to attain an increase in quality of life are highlighted. References Chmielinski A, Koons B. Nursing care for the patient with a left ventricular assist device. Nursing 2018. 2017;47:34–40. Montalto A, Loforte A, Musumeci F, Krabatsch T, Slaughter M (Eds.). Mechanical circulatory support in end-stage heart failure: a practical manual. Cham, Switzerland: Springer International Publishing; 2017. doi:10.1007/978-3-319-43383-7