The mechanical circulatory support (MCS) team is based at Harefield Hospital, and works as part of the wider transplant team.
We initially meet patients during their heart transplant assessment process. If it is decided that their treatment will involve a left ventricular assist device (LVAD) or another type of MCS, a member of the team will meet with the patient to discuss the plan and the device.
We go with the patient to theatre and remain with them during the implant of the device, and are involved in the surgical procedure. We then follow the patient to the intensive therapy unit (ITU) and the wards, monitoring their condition throughout
Once the patient is beginning to rehabilitate, we will teach them about the device and how to manage at home. We train them in how to deal with everyday situations and emergencies, and also show a family member how to change the dressing associated with the device. On discharge, we will speak with the patient’s local community support, including their GP, and local A&E and ambulance services.
We provide a 24-hour on-call service for patients and other hospitals to contact us in case of emergency. We have a dedicated phone number that patients can call at any time to talk with a member of the team, and we will continue to see the patient as long as they have the LVAD or MCS in situ. They are followed up in our clinic on a regular basis.
We also have nurse prescribers within the team and manage many of our patient’s warfarin dosing using the CoaguChek system (a small portable device to monitor anticoagulation levels by taking a small drop of blood from the finger) to check international normalised ratios (INR).