Ventricular assist devices as destination therapy: psychosocial and ethical implications

Sherry Grogan, Kristin Kostick, Estevan Delgado, Courtenay Bruce

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

One of the candidate evaluation challenges is determining when and how psychosocial domains influence short- and long-term destination therapy ventricular assist device (DT-VAD) outcomes. There are very few DT-VAD studies and no validated instruments to identify psychosocial risk factors. General practice is to borrow from the transplant literature, which may not be applicable to this unique device application. We question the relevance of using transplant psychosocial evaluation for patients who are candidates for DT-VAD only, particularly because these patients require a certain level of cognitive, psychological, and behavioral functioning to ensure proper long-term self-care with the VAD. We may be missing important psychological characteristics in our pre-evaluations by "borrowing" from the transplant literature, thereby underplaying significant factors that are especially relevant for DT-VAD candidates. Conversely, we may be screening out candidates who may benefit greatly from DT-VAD by using transplant criteria as part of the screening process. We use a case study to illustrate some of the challenges of weighing psychosocial risk factors in the DT-VAD population and to emphasize the need for developing distinct psychosocial assessment criteria for DT-VAD patients.

Original languageEnglish (US)
Pages (from-to)9-11
Number of pages3
JournalMethodist DeBakey cardiovascular journal
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • DT-VAD
  • destination therapy ventricular assist device outcomes
  • psychosocial factors mechanical circulatory support

ASJC Scopus subject areas

  • Medicine(all)

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