Before receiving an LVAD, you’ll go through an important evaluation process to ensure you’re a good candidate for the device and that you have the best chance of success. This evaluation involves a thorough review of your medical history and current health, followed by a series of tests and interviews conducted by a multidisciplinary team. Here’s what you can expect during this phase:
The Team
The evaluation team typically includes a wide range of medical professionals, each with a specific role in assessing your suitability for an LVAD. You may meet with:
- Social Worker: Helps assess your emotional and social well-being and prepares you for the challenges of life with an LVAD.
- Palliative Care Doctor or Nurse Practitioner: Reviews the overall approach to managing your symptoms and improving quality of life.
- Surgeon: Discusses the procedure itself and your ability to undergo surgery.
- VAD Coordinators: Specialize in managing the LVAD system and its follow-up care.
- Doctors and Hospital Staff: Review your overall health and medical conditions.
- Occupational and Physical Therapists: Evaluate your physical condition and how you’ll adjust post-surgery.
- Dental and Nutritionist: Assess dental health (important for infection prevention) and nutritional needs.
These roles may differ depending on where you’re receiving care, but the overall goal is to make sure every aspect of your health and well-being is considered.
The Tests
A series of tests will be conducted to ensure you are physically capable of undergoing surgery and recovering successfully. These tests are non-invasive and may include:
- Blood work
- Heart function tests (such as an echocardiogram)
- X-rays or imaging studies
- Pulmonary function tests
- Kidney and liver function assessments
These are tests you’ve likely encountered before, and none of them should be painful. They help doctors assess whether your body is strong enough for the LVAD procedure and recovery.
The Decision-Making Process
Once all the tests are completed and interviews with the team are conducted, they will come together to review your case. They will consider your medical history, the results of the tests, your social and mental health readiness, and more. The team will vote on whether you’re a good candidate for the LVAD procedure.
Afterward, you’ll be notified of their decision. It’s possible that you might be denied at first, but there’s often an opportunity for reconsideration. For example, if you are advised to quit smoking, stop drinking alcohol, or get certain dental work done, you could qualify for the LVAD in the future once those requirements are met.
Not Everyone is a Candidate
While the LVAD can provide life-saving benefits, not everyone is a good candidate for the procedure. The team evaluates each individual case to ensure that the patient will have the best chance for success and a positive outcome. If you are denied, it doesn’t mean you’re out of options—it could simply mean that with some lifestyle changes or medical treatments, you might qualify in the future.
This evaluation process ensures that the decision to proceed with an LVAD is in the best interest of your health and future. It may feel like a lot to go through, but each step is part of setting you up for the best possible outcome after surgery. Consult with your medical team if you have concerns.