Introduction: Heart failure is a complex and progressive disease associated with poor prognosis and significantly reduced quality of life and increased risk of death (1,2).
Case report: Patient NN, born in 1959, due to advanced heart failure caused by dilated cardiomyopathy, since 2014 has been a carrier of mechanical circulatory left ventricular assist device (LVAD), and in 2020 undergoes a successful heart transplant procedure. Only some of his hospitalizations are: 2002 myocardial infarction, 2009 cerebrovascular insult with successful recovery, but later that year he was hospitalized again due to an epileptic attack. In 2014 implantation of LVAD (Hart Mate II), 2015 total hip arthroplasty complicated by retroperitoneal and with a subfascial hematoma of the right upper leg and a lesion of the femoral nerve. The same year he was diagnosed with colon cancer, after which he underwent multiple tubular polypectomies adenoma. The patient also has chronic kidney disease, gastritis, hemorrhoids, chronic obstructive pulmonary disease, nephrolithiasis, kidney cyst, cholecystolithiasis, pulmonary hypertension. In 2017, he was fitted with a Cardiac Resynchronisation Therapy (CRT-D). In 2019 suspected LVAD “driveline” infection (Enterobacter cloacae bacteremia, Enterococcus faecalis and others). Consequently, the development of cardiogenic shock, implanted VA ECMO and new HM II pump. In 2020 treatment of anemia followed by heart transplantation in the same year. Nursing diagnoses in patients with these comorbidities are high risk for infection, pain, anxiety, ignorance and the health care process is based on solving the same.
Conclusion: LVAD has enabled numerous patients with advanced heart failure a better future. In this example, we see a man who despite numerous diagnoses he did not give up his belief in the positive outcome of the treatment and eventually received a heart transplant. All the above would be unimaginable without the continuous efforts of the health care staff, the patient’s wishes for recovery, as well as the successful multi-year support of LVAD.