OUT-OF-HOSPITAL EXPERIENCE IN PATIENTS WITH IMPLANTABLE MECHANICAL CIRCULATORY SUPPORT - PRESENT AND FUTURE-TRENDS

From March 1993 to August 1995, 33 patients received implantable VAD s ystems at our center. Nineteen patients received the wearable Novacor LVAS and 14 patients the TCI HeartMate device. Both systems enable the patients to be mobilized very quickly and some of them even do not re quire critical care after a few days. In our series 17 patients (eight Novacor, nine TCI) could be transferred to the normal floor. The wear able electrically driven Novacor system opens the opportunity of sendi ng patients out of hospital. Since July 1994 we have referred five pat ients to a rehabilitation center, and six patients were sent home, thr ee of them for more than 70 days. A number of factors are necessary to prepare the patient for being discharged. One of the most important t hings is to guarantee ambulatory patient care and to find an easy way for effective home monitoring. Our experience has shown that dischargi ng these patients means giving them a maximum in quality of life and d ecreasing the costs by more than 50% in comparison to a stay in hospit al for the whole time. Our results are encouraging to improve this str ategy in the future. (C) 1997 Elsevier Science B.V.