Postoperative Patient Care with a Telemedicine Based Innovative App After Left Ventricular Assist Device Implantation

Background: Patients with a left ventricular assist device (LVAD) require intensive follow-up due to complications such as driveline infections, right ventricular failure, technical device issues, and anticoagulation-related problems. Additional challenges like hypovolemia and patient adherence complicate their management. To prevent complications, ensure early detection and treatment, and better inform and connect patients to the outpatient clinic, additional telemonitoring was introduced. The aim of the study was to analyze the assessment of an additional telemedicine tool in postoperative patient care after LVAD implantation.

Methods: An app-based program with daily engagement reminders was developed for LVAD patients, accessible through smartphones or computers. The app includes daily questionnaires addressing vital signs, VAD parameters, anticoagulation status, wound condition, overall well-being, and any complications. Individual pathways for each LVAD system and specific anticoagulation regimens were created to enhance patient-tailored management. It also features a self-education library, reminders, a chat tool, and options for secure data transmission. We included 27 patients in our study: 19 (60%) secondarily (30.5 ± 20.9 months after discharge) and 8 (40%) primarily (before discharge) after LVAD implantation. Patients with Total Artificial Heart (TAH), right or biventricular devices were excluded from this study. An online survey was conducted after 1 year.

Results: The mean age of the 24 male and 3 female patients was 55.5 ± 2.3 years. The app was used for an average of 8.0 ± 1.5 minutes daily, with no reported discontinuation. Most users found the app well-tailored to their needs, reporting an average satisfaction score of 8.2 out of 10. Of the patients included secondarily, 68% felt there was no change in follow-up care quality, but 32% believed the app provided enhanced security. The feature My Tasks was the most favored (88.9%), followed by Photo Sharing (59.3%) and Chat Function (48.1%).

Conclusion: The app demonstrates effectiveness in supporting LVAD patient management and engagement, with high satisfaction rates and consistent usage. Its intuitive design ensures ease of handling for patients, facilitating seamless integration into their daily routines. Early inclusion is crucial for promoting patient adherence and overall success. Future studies should explore the app’s impact on hospital admissions, preventive care, and the frequency of patient–provider interactions to further optimize care and resource utilization.

 

MissingLinkText

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
11 February 2025