The consequences of the COVID‐19 pandemic for self‐care in patients supported with a left ventricular assist device

Abstract

Self-care is essential for patients supported with a Left Ventricular Assist Device (LVAD) to prolong survival and maintain a good quality of life.(1) Adequate self-care can decrease the risk of infection, bleeding, pump thrombosis, cerebral events, and other complications related to the device or to the various co-morbidities that are common in this group of patients. (2) Patients and their caregivers receive intense education and support on how to perform appropriate self-care and to cope with factors that may hinder optimal self-care. However, with the recent pandemic COVID-19, LVAD supported patients, their close caregivers and the healthcare professionals face some completely unprecedented and unexpected challenges that may affect their ability to maintain optimal self-care. Patients with cardiovascular risk factors and established cardiovascular disease represent a vulnerable population when suffering from COVID-19 and patients with cardiac injury in the context of COVID-19 have an increased risk of morbidity and mortality. (3) In this short communication we summarize some of the consequences of the COVID-19 pandemic for self-care of LVAD patients, with the aim to support the patients, their caregivers, and healthcare providers and to offer some input on self-care related challenges that are probably similar worldwide. This paper might also guide future education programs and organisational strategies to prepare for similar crises. This viewpoint paper presents guidance to centres that -until now -might not have organised ambulatory care and education protocols for their LVAD supported patients. Other centres might already have such care on a distance in place and can serve as a model of 'best practices' to those who need to reorganize care for those patients. This viewpoint is based on experiences from centres that have experience with LVAD patients during the Covid19 pandemic in different professional roles in different European countries. Self-care for LVAD supported patients includes care for the system and the driveline, maintaining a healthy lifestyle, and adhering to the prescribed medical regimen. (1) Additionally, LVAD supported patients and caregivers should monitor signs and their symptoms including regularly monitoring device and vital parameters, which changes may require prompt recognition and actions. Threats for appropriate self-care imposed by COVID-19 are related not only to the occurrence of the disease itself, but also to social constraints, transportation restrictions, social distancing, difficulties in accessing drugs and supplies as needed, and psychosocial stress.(4) Essential self-care behaviour and threats/challenges during the COVID-19 pandemic include:This article is

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