Thorac Cardiovasc Surg 2014; 62(05): 409-413
DOI: 10.1055/s-0033-1351352
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Experience with a “Hotline” Service for Outpatients on a Ventricular Assist Device

Hector Rodriguez Cetina Biefer
1   Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
,
Simon Harald Sündermann
1   Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
,
Maximilian Yosri Emmert
1   Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
,
Peter Hasenclever
1   Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
,
Mario Louis Lachat
1   Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
,
Volkmar Falk
1   Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
,
Markus Johannes Wilhelm
1   Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
› Institutsangaben
Weitere Informationen

Publikationsverlauf

20. Februar 2013

26. Juni 2013

Publikationsdatum:
29. August 2013 (online)

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Abstract

Objectives With the growing number of outpatients on ventricular assist devices (VADs), there is an increasing need for “home discharge programs.” One important feature is a 24-hour telephone service. In our center, the perfusionists run a so-called “hotline” for all of our VAD patients. This study analyzes the hotline calls with regard to frequency, the reason for calling, and the type of action undertaken.

Patients and Methods Over a period of 5 years, 16 (12 EXCOR and 4 INCOR; Berlin Heart, Berlin, Germany) of 33 VAD patients (48%) were discharged and instructed to use the “hotline” service. All the calls received by the perfusionists were reviewed. We classified the calls into three levels according to the severity of the problem: Level (L) 1 = assistance provided by the perfusionist alone; L2 = calls requiring discussion with the surgeon on duty and/or visit to the outpatient clinic ahead of time; and L3 = immediate action and/or admission to the hospital.

Results Over a period of 2,890 outpatient days (7.9 years), a total of 26 calls were registered. There were 0.9 calls per 100 patient days and 1.6 calls per discharged patient. Out of the 26 calls, 14 calls (54%) were classified as L1, 8 (31%) as L2, and 4 (15%) as L3. The most frequent reasons for L1 or L2 calls were fibrin deposits in the EXCOR pump chamber (39%), followed by battery dysfunction (19%). L3 calls were related to dysfunction of the EXCOR driving units in three cases and to an EXCOR pump chamber disconnection, which the patient did not survive.

Conclusions The institution of a hotline is an essential component of a VAD outpatient program. It provides a certain level of safety for the patient, although a residual risk remains.

Note

Abstract was presented at the 2011 annual meeting of the German Society for Thoracic and Cardiovascular Surgery in Stuttgart, Germany.