| Table 17: Checklist- Assessment for Mechanical Circulatory Support |
| Issue |
Assessment Items |
| Cardiac Assessment |
- Full assessment of ventricular, valvular function, assessment of hemodynamics with particular view to potential reversibility of condition.
- Right ventricular function- will the patient require biventricular support? (higher risk)
- Rapidity of cardiac decompensation (rapid deterioration mitigates toward temporary support)
|
| Surgical History |
- Previous sternotomy
- Is this early post-pericardiotomy? (higher risk)
- Does the patient have a prosthetic valve, which will need replacement at the time of VAD insertion?
- Vascular access, device and patient technical considerations
- Ability to withstand major surgical procedure
|
| Other Medical Issues |
- Active infection, Coagulopathy, liver dysfunction, renal function, cognitive/ neurological status
- Are other conditions which limit operational or long term survival present?
|
| Cardiac transplant eligibility |
- Is there time to consider cardiac transplantation eligibility?
- If not, temporary device consideration suggested
|
| Advanced care planning Issues |
- Patient preferences for care
- Has the patient outlined goals of care?
|
| Psychosocial considerations |
- Can the patient maintain self care at home?
- Are sufficient home or family supports available, and are they engaged in pre-operative planning and decision making?
|