000			03349nam a22004337a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a2224-5820
024			_aapm-23-551 [pii]
040			_aOvid MEDLINE(R)
099			_a38462933
245			_aThe role of palliative care for patients with left ventricular assist devices: a narrative review.
251			_aAnnals of Palliative Medicine. 2024 Feb 27
252			_aAnn. palliat. med.. 2024 Feb 27
253			_aAnnals of palliative medicine
260			_c2024
260			_p2024 Feb 27
265			_saheadofprint
265			_tPublisher
266			_d2024-07-23
520			_aBACKGROUND AND OBJECTIVE: Left ventricular assist devices (LVADs) have revolutionized the care of patients with advanced heart failure (HF). Compared to guideline-directed medical and device therapies, LVAD technology improves quality of life and reduces mortality. Palliative care specialists have an important role to play in the pre-LVAD evaluation phase, in the post-operative longitudinal care phase, and at the endof-life in patients with LVADs. The objective of this narrative review is to describe the evidence regarding the role of palliative care for patients with LVAD across the care continuum: pre-implantation, postimplantation, and at the end-of-life.
520			_aCONCLUSIONS: In this narrative review, we describe the integral role of palliative care throughout the care continuum of patients living with LVADs and suggest opportunities for further research.
520			_aKEY CONTENT AND FINDINGS: Palliative care involvement in 'preparedness planning' has been described in the literature, though no standardized protocol for preparedness planning exists, to date. In the longitudinal care phase after LVAD implantation, the role of palliative care is less defined; depending on institutional culture and availability of palliative care, patients may be referred based on symptom-management needs or for advance care planning (ACP). At the end-of-life, either due to an acute event or a gradually worsening condition, palliative care is often engaged to participate in discussions regarding treatment preferences and to consider transitions in care from disease-directed treatments to comfort-focused treatments. Given the medical complexity of dying with LVADs, most patients with an LVAD die in hospital with support from palliative care teams for the physical, existential, and psychosocial distress that accompanies end-of-life and LVAD deactivation.
520			_aMETHODS: Clinical trials relevant to care of patients with HF, LVADs, and the role of palliative care were analyzed for this narrative review.
546			_aEnglish
650			_zAutomated
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aMedicine/Palliative Care
657			_aJournal Article
700			_aBalsara, Keki _bMHVI
700			_aGroninger, Hunter _bMWHC
700			_aGupta, Richa _bMHVI
700			_aRao, Anirudh _bMWHC
700			_aSheikh, Farooq H _bMHVI
790			_aAbdullah B, Gupta R, Anderson KM, Balsara K, Sheikh FH, Groninger H, Rao A
856			_uhttps://dx.doi.org/10.21037/apm-23-551 _zhttps://dx.doi.org/10.21037/apm-23-551
942			_cART _dArticle
999			_c14215 _d14215