On the road to immersion (Week 4)

It has been four weeks since I started immersion, and looking back, I have learned a lot. I came here wanting to know the behind the scenes of the care provided to patients implanted with ventricular assist devices (VADs). Through my time spent here, I have managed to find answers to the following questions:

1)      What happens during a typical clinical visit of an advanced heart failure patient implanted with a VAD?

2)      How is the VAD speed set and the performance evaluated?

3)      What are the different biomarkers that are quantified to ensure that a patient is doing well?

4)      What surgical procedures are adopted for VAD implantations?

5)      How are decisions taken whether a particular patient will receive a VAD implant?

This week, I was fortunate enough to attend a meeting where the got my answer for the last question shown above. In the meeting, patients (along with their clinical history) were presented as candidates for VAD implants. It was fascinating to see that not only the state of the cardiovascular system is evaluated, but also all other organ systems of the body are checked to determine whether the body can take the stress/toll of the VAD surgery. The meeting proceeded with specialists of different systems like respiratory, neurology, renal, etc., providing their inputs about the likelihood of a particular organ system being ‘healthy enough’ to take the toll of the surgery. After all inputs are gathered, decisions were taken based on the general opinion on whether the patient in question will undergo the implant or not. It was also very interesting to know that if a patient is too sick, a VAD implant is not possible, and the patient can be refused. In addition, I saw more post-op patients undergoing standard clinical check-ins.  A significant portion of the week was spent shaping my research project, which I have started and made some progress.  In summary, it was a good week working with my mentor Dr. Irina Sobol.

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