Comparison of Psychosocial and Economic Problems and Quality of Life in Patients Following Heart Transplantation or Left Ventricular Assist Device Implantation

Background: The use of left ventricular assist devices (LVADs) has become increasingly common as a treatment to extend lifespan and improve the quality of life (QOL) for patients awaiting heart transplantation (HT) or those ineligible for HT. However, patients with an LVAD often experience various challenges. Aim: This study aimed to compare the QOL of patients following LVAD implantation and HT, and to identify the problems experienced by LVAD patients. Methods: This descriptive study was conducted through face-to-face interviews with 66 patients (LVAD = 21; HT = 45) having had undergone surgery in the adult cardiovascular surgery clinic of a university hospital and later visited the cardiology outpatient clinic for a follow-up. Data were collected using a “Determination Form for Sociodemographic Characteristics and Problems Associated with LVAD and HT” and the “Short Form-36 (SF-36) Quality of Life Scale”. Data analysis included t-tests, analysis of variance (ANOVA), and multiple regression analysis. Results: The mean age of the participants was 39.3 ± 15.7 years. The majority of patients in both groups were male and single. The survival time of patients who underwent HT was longer than that of patients who received a LVAD implan- tation. Among heart transplant patients, issues such as depression, anger, personality and attitude changes, and anx- iety were identified. Patients with LVAD implants primarily experienced depression, fear, and anxiety about the future. Complications such as infection, thrombosis, and bleeding were more common in LVAD patients, while heart transplant patients experienced complications including tremors, diabetes mellitus, osteoporosis, hypertension, and infections. Most patients in both groups reported being unemployed and facing economic difficulties. Conclusion: Although the clinical QOL improves following LVAD implantation, better outcomes are generally achieved after HT. Social, psychological, and sexual challenges significantly impact patients' overall well-being. It is believed that preparing patients for the postoperative period may help identify potential problems early and support their adaptation to the recovery process.