P35: A New Opportunity for Patient Selection & Optimization: Systematic Review of Cognitive Frailty in Patients Undergoing LVAD Implantation

Left ventricular assist device in cognitive impairment: A favorable destination despite poor prognosis?

“…In any case, assessment of cognitive function remains important. In this respect, the systematic review reported by Yu et al 6 will raise more important issues in this clinical field.…”

“…5 In this issue of this journal, Yu et al performed a systematic review and reported that cognitive impairment before left ventricular assist device (LVAD) implantation was associated with prolonged length of stay (LOS), increased readmissions, increased incidence of stroke, and increased mortality. 6 Montreal Cognitive Assessment (MoCA) was the most widely used method of cognitive assessment, and the mean scores reported fell in the MCI class. It was suggested that advanced HF patients with MCI should undergo further evaluation prior to LVAD implantation, through multidisciplinary discussion based on regional institutional expertise.…”

“…It was suggested that advanced HF patients with MCI should undergo further evaluation prior to LVAD implantation, through multidisciplinary discussion based on regional institutional expertise. 6 Preserved cognitive function is particularly important for HF patients considering LVAD implantation owing to the complexity of device operation and maintenance. The International Heart and Lung Transplant Society recommends that all LVAD candidates should be assessed for their cognitive ability to properly operate and maintain the device, and that patients with cognitive impairment should be considered a contraindication to LVAD implantation.…”