Psychosocial and quality of life issues in mechanical circulatory support

The use of mechanical circulatory support (MCS) as a long-term therapy for end-stage heart failure is associated with many psychosocial considerations for both patients and their families. These considerations span the process of care: they encompass factors including evaluation, informed consent, and decision-making before implantation; health-related quality of life and behavioral outcomes during and after MCS implantation; impact of psychosocial factors on clinical outcomes after MCS implantation; and end-of-life concerns. Like many other medical interventions, the success of MCS is ultimately judged by its ability not only to prolong life but also to maximize psychosocial and physical well-being. Hence, it is critical for health care providers and researchers alike to understand the key psychosocial issues that emerge at each step in the process of MCS intervention, as well as the empirical evidence available regarding them. Better understanding of the issues and related evidence is important for improved education of patients and their families, especially since long-term MCS is a viable treatment option. It is also important for the development and evaluation of new strategies to maximize psychosocial outcomes in patients receiving MCS.