ORCID
0000-0001-5947-4778 (Yehya)
Document Type
Article
Publication Date
2025
DOI
10.1016/j.jaccas.2025.103944
Publication Title
JACC: Case Reports
Volume
30
Issue
18
Pages
103944
Abstract
[Case] Mr H is a 74-year-old man with history of end-stage heart failure (ESHF) secondary to hereditary transthyretin cardiac amyloidosis. Our patient underwent placement of a HeartMate II (Abbott) left ventricular assist device (LVAD) as destination therapy (DT) at an outside hospital and later came to us (Sentara Heart Hospital) for continued management because he resided in the area. Over a 2-year period, the patient experienced multiple hospital admissions for acute heart failure (HF) exacerbations, delirium, and recurrent low-flow alarms. During his last hospitalization, the palliative medicine team was consulted to facilitate goals-of-care discussions with the patient and his family, thereby ensuring appropriate symptom management. Following these discussions, Mr H and his family elected to prioritize comfort and opted for a transition to hospice care at home. The low-flow alarm is a critical tool for detecting, preventing, and addressing underlying disease. This potentially lifesaving alarm cannot be disabled. For patients with HeartMate II LVAD support, patients can silence their own alarms for only 2 minutes on their system controller. These alarms cannot be permanently silenced; the longest suppression period is a 4-hour extended silence, which cannot be performed at home. Additionally, silencing requires connecting the system controller to a power module and system monitor, both of which are costly and unavailable outside of hospital or clinic settings.
Rights
© 2025 by the authors.
Published under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.
Original Publication Citation
Munir, M. Z., Galicia-Castillo, M. C., Achitoov, M., & Yehya, A. (2025). Left ventricular assist device destination therapy: A journey to home and beyond. JACC: Case Reports, 30(18), 1-4, Article 103944. https://doi.org/10.1016/j.jaccas.2025.103944
Repository Citation
Munir, M. Z., Galicia-Castillo, M. C., Achitoov, M., & Yehya, A. (2025). Left ventricular assist device destination therapy: A journey to home and beyond. JACC: Case Reports, 30(18), 1-4, Article 103944. https://doi.org/10.1016/j.jaccas.2025.103944
Included in
Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons, Cardiology Commons, Cardiovascular System Commons, Palliative Care Commons