Patient planning tool

Considerations for developing a case-by-case patient management plan

This tool is intended to help clinicians develop personalized management plans for HVAD™ patients. Content in this tool is based on recommendations in previously published Field Corrective Actions (FCAs) and is not intended to be prescriptive. As always, patient care decisions should be made by practitioners on a case-by-case basis, based on their clinical judgment.

This tool will be updated as needed; please bookmark and refer back to this page regularly.

Use this Planning Worksheet to develop a case-by-case assessment for your patients.

More information

For complete information regarding patient management recommendations, please reference the mechanical circulatory support HVAD product advisories via the Medtronic website.

For additional HVAD™ patient management resources, please consult the Medtronic manual library, and contact your local Medtronic field representative.

Use this Planning Worksheet to develop a case-by-case assessment for your patients.

• Delay or failure to restart discussion guide and worksheet for case-by-case assessment plan
  • Bridge to Transplant, Candidacy, or Recovery
  • Destination Therapy
  • Bridge to Transplant, Candidacy, or Recovery, When Modified Controller Not Available
  • Destination Therapy, When Modified Controller Not Available
  • Revisiting the Medium Priority [Controller Fault] Alarms
  • Planning Worksheet
• HVAD controller programming and use of the disable “VAD Stop“ alarm button
• Controller port bent pins — replacement of power source and data monitor cables
• Hardened driveline cover hindering driveline disconnection
• Driveline cover management following strain relief repair
• Pump weld non-conformance

Delay or failure to restart discussion guide and worksheet for case-by-case assessment plan

For complete information regarding patient management recommendations, please reference the mechanical circulatory support HVAD product advisories via the Medtronic website.
 

Recommendations for patient management:

In consultation with the MCS Independent Practitioner Quality Panel, Medtronic recommends:

• That treatment decisions for all patients should be determined on an individual case-by-case basis 
• That healthcare providers have prepared an individualized patient management plan for each subgroup patient, especially patients in subgroup 2
• That healthcare providers upload controller logfiles to Autologs and/or HVADlogs with each patient visit and review reports (e.g., the reports include pump parameters, motor start events, alarms, power disconnects)
• That healthcare providers routinely speak with their patients to emphasize avoidance of unnecessary pump stops and reinforce education regarding device management and alarm troubleshooting
• That patients do not exchange their controller unless explicitly directed by a high priority alarm condition or a VAD team member
• That controller exchanges are performed in a clinical setting, and with immediate hemodynamic support available especially for subgroups 1, 2, and 3

Factors to consider for a controller exchange include but are not limited to:

• Whether the patient is a candidate for a pump exchange if the pump does not restart
• The existence of a do not resuscitate (DNR) order and co-morbidities
• Length of time the patient is expected to remain on therapy; examples include but are not limited to bridge to transplant care and/or therapeutic recovery potential
• Distance/time it will take for the patient to reach the hospital/clinic for support
• Patient and caregiver understanding/compliance to alarm response protocols and power source management to prevent unnecessary pump stops

View the mechanical circulatory support HVAD product advisories.

For additional HVAD™ patient management resources, please consult the Medtronic manual library and contact your local Medtronic field representative.