Advanced Heart Failure Treatment Modalities and Hospice Care: The Need for High Level Care Coordination

Abstract

Advanced heart failure therapies such as ventricular assist devices and home inotrope use are becoming more common. Technology advances as well as increased indications for use of such therapies is leading to a higher percentage of patients with end-stage heart failure receiving these therapies at end of life. We present a case of a young man with dilated cardiomyopathy who undergoes advanced cardiac care in the setting of progressively declining cardiac function. Our case outlines the importance of acute care, palliative care, and hospice services being coordinated prior to and during acute-care services to provide goal-concordant and expeditious care. With advancing medical therapies for heart disease, increased coordination and collaboration of services are needed, particularly between hospice and acute-care services.

Keywords

advanced heart failure hospice palliative care cardiomyopathy inotropes

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References

Kadakia

Morre

Ambur

Toyoda

. Current status of the implantable LVAD. Gen Thorac Cardiovasc Surg. 2016;64(9):501–508.

Holmberg

Ahn

Peterzen

. More than 20 years experience of theft ventricular assist device implantation at a non-transplant centre. Scand Cardiovasc J. 2017;51(6):293–298.

Tariq

Aronow

. Use of inotrope agents in treatment of systolic heart failure. Int J Mol Sci. 2015;16(12):29060–29068.

Kitko

Hupcey

Burriel

Alonso

. Patients’ decision making process and expectations of a left ventricular assist devices pre and post implantation. Heart Lung. 2016;45(2):95–99.

Brush

Budge

Alharethi

. End-of-life decision making and implementation of a destination left ventricular assist device. J Heart Lung Transplant. 2010;29(12):1337–1341.

Warraich

DeVore

, et al. Trends in hospice discharge and relative outcomes among Medicare patients in the get with the Guidelines-Heart Failure Registry. JAMA Cardiol. 2018;3(10):917–926.

NHPCO Facts and Figures. 2017. https://www.nhpco.org/sites/default/files/public/Statistics_Research/2017_Facts_Figures.pdf. Accessed September 16, 2018

Shunichi

Garan

. Hospice use and palliative care for patients with heart failure never say never in medicine, but it is never too early to start the conversation. JAMA Cardiol. 2018;3(10):926–928.

Groninger

Gilhuly

Walker

. Getting to the heart of the matter: a regional survey of current hospice practices caring for patients with heart failure receiving advanced therapies. Am J Palliat Care. 2019;36(1):55–59.

10.

Patel

D’Souza

Groninger

. Continuous inotrope therapy in hospice care: a case series [published online January 10, 2019]. Am J Hosp Palliat Care. 2019.

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