Neuropsychological Assessment of Adults Being Considered for Mechanical Circulatory Support

Abstract

Heart failure (HF) is a complex clinical syndrome characterized by impaired myocardial performance and neurohormonal abnormalities that lead to circulatory insufficiency and congestion. In practice, the determination of HF is a clinical diagnosis based on the patient's history and physical examination, as no single test alone is diagnostic. In patients with refractory HF, a heart transplant is generally considered the best option for treatment, with high rates of 1-year survival and up to 60% survival over 10 years. However, the viability of this option is limited by organ availability. Furthermore, some patients may not be suitable transplant candidates, or their risk profile may increase (due to health decompensation) while on waiting lists. This has led to the use of methods for mechanical circulatory support (MCS) to increase patient survival, improve quality of life, and reduce morbidities. While there are many methods for MCS, the left ventricular assist device is one of the most commonly used. It is critical to provide the cardiac team with education regarding how a neuropsychological evaluation can be performed validly. Obtaining a collateral interview is key for ascertaining whether cognitive impairment occurred exclusively in the context of acute cardiac decompensation. (PsycInfo Database Record (c) 2021 APA, all rights reserved)