Long-Term Left Ventricular Assist Device Support as Destination Therapy: Caregiver Burden as an Outcome Measure
DOI:
https://doi.org/10.5281/zenodo.22498101Abstract
Left ventricular assist devices (LVADs) were developed as abridge to heart transplantation, but a growing majority of
implants are now destination therapy: intended as a patient's final circulatory support rather than a step toward transplant
[1]. That shift was made possible by two decades of steadily improving survival and adverse-event outcomes, from the
original REMATCH trial's 52% one-year survival through the fully magnetically levitated HeartMate 3's 58% five-year
survival in MOMENTUM 3 [1,2]. It was also made possible, less visibly, by an assumption built into nearly every implant
protocol: that a family member or friend will be identified before surgery and will take on an open-ended, often
years-long role managing a driveline exit site, battery and controller changes, alarm response, and emergency recognition
at home
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