Diretriz de assistência circulatória mecânica da sociedade brasileira de cardiologia

Comunicação efetiva para o cuidado seguro ao paciente com implante de dispositivo de assistência ventricular

“…Based on this experience and recommendations (3,8) , the professionals created protocols for patient care during and after hospitalization containing guidelines such as wound care, checking mean arterial pressure, and different system verification checklists with recommended frequency. Corroborating with the literature (9) , our experience shows that multidisciplinarity constructed using checklists optimizes communication between teams and patients, boosts compliance with quality and safety standards, and reduces infection, thus enabling the structuring and daily review of the established therapeutic and self-care routines.…”

“…When HF is in the advanced stage and refractory to optimized treatment, the heart transplant (HT) is a therapeutic option for patients selected according to clinical criteria and specific conditions (2) . In patients with contraindication or patients who cannot undergo HT in the short term, ventricular assistance devices (VAD) can provide hemodynamic support and clinical stability as a bridge to HT or even as a destination therapy (3) .…”

“…However, VAD is incipient in Brazil mostly because of its high cost. There is no Brazilian record of mechanical circulatory assistance (3) , but a few dozen implants are estimated to have occurred, especially in the southeast.…”

“…The VAD consists of a mechanical pump surgically implanted in the patient's heart with inlet and outlet tubes, a blood pump, a device output cable (driveline), and external power sources. The purpose of the device is to provide adequate cardiac output and reduce the work of the left ventricle (3) . Such a highly complex therapy allows patients to return to their usual activities although longterm success partly depends on their follow-up by qualified teams (5) and the correct selection of patients (3) .…”

“…The purpose of the device is to provide adequate cardiac output and reduce the work of the left ventricle (3) . Such a highly complex therapy allows patients to return to their usual activities although longterm success partly depends on their follow-up by qualified teams (5) and the correct selection of patients (3) . The average survival rate after the implant is five years and major complications include infection, right HF, neurological disorder, malfunction of the VAD, and multiple organ dysfunction (4) .…”