Sequence # Data Field Field Definition Data Field Intent / Clarification Source Document 1920 VAD

Transcription

1 Section L: VAD Section Intent: The intent of this section is to identify and collect information concerning VAD placement, including: Indication for VAD; VAD Implant type; VAD Explant reason; and VAD s. Sequence # Data Field Field Definition Data Field Intent / Clarification Source Document 1920 VAD Indicate if the patient, during a previous Previous VAD hospitalization, received a mechanical ventricular assist device, pneumatically or electrically controlled, that supports the pumping chambers of 1930 VAD Indication for initial VAD the heart. Indicate the reason the patient is receiving the initial ventricular assist device ( VAD): - Bridge to Transplantation: Includes those patients who are supported with a VAD until a heart transplant is possible. - Bridge to Recovery: Includes those patients who are expected to have ventricular recovery (i.e. Myocarditis patients, postcardiotomy syndromes, viral cardiomyopathies, AMI w/ revascularization, and post-transplant reperfusion injury). - Destination: Includes those patients where a heart transplant is not an option. The VAD is placed for permanent life sustaining support. - Postcardiotomy Ventricular Failure (Separation form CPB): Includes those Postcardiotomy patients who receive a VAD because of failure to separate from the heart-lung machine. Postcardiotomy refers to those patients with the inability to wean from cardiopulmonary bypass secondary to left, right or biventricular failure. - Device Malfunction: Includes those patients who are currently VAD supported and are experiencing device failure. Please note that future references to Initial VAD refer to the initial VAD for this hospitalization, not a VAD placed during a previous hospitalization.

2 1940 VAD Intubated Pre VAD Indicate if the patient was intubated prior to the OR in which the VAD was placed VAD Pre-VAD PCWP Indicate the Pulmonary Capillary Wedge Pressure (PCWP) in mm/hg as determined prior to induction in the OR, or in an ICU immediately prior to the OR. notes 1960 VAD PreVAD CVP 1970 VAD PreVAD-PVR 1980 VAD PreVAD CI 1990 VAD PreVAD RVEF 2000 VAD PreVAD RVEF Method Indicate the Central Venous Pressure (CVP) in mm/hg prior to induction in the OR, or in an ICU immediately prior to the OR. Indicate the Pulmonary Vascular Resistance (PVR) prior to induction in the OR, or in an ICU immediately prior to the OR. Please collect the value in woods units. If you institution reports PVR as dynes sec/cm5, please convert using the formula below. PVR in Woods units = (MPAP-PCWP)/CO PVR in dynes sec/cm5 = (MPAP-PCWP)/CO x 80 Indicate the Cardiac Index (CI) in L/min/m2 prior to induction in the OR, or in an ICU immediately prior to the OR. Indicate the Right Ventricular Function prior to anesthesia induction in the OR and as close to time of the VAD implant as possible. Normal Mildly Impaired Moderately Impaired Severely Impaired Indicate the method the RV Function was obtained. Preop Echo Intra-op pre VAD TEE TEE = Transesophageal Echo ICU Flow Sheet Cath Report Anesthesia Record Right Heart Cath Cath Report Anesthesia Record Echo Report Echo Report

3 2010 VAD PreVAD PVO2 Measured Indicate whether a stress test with VO2 measurement was performed prior to the VAD placement. The Peak VO2 is the peak oxygen consumption during exercise. Peak VO2 may or may not have been obtained prior to VAD placement because of the Cardiology Reports Outpatient Clinic Chart 2020 VAD PreVAD PVO2 timing status to VAD placement. Indicate the peak VO2 in ml/kg/min prior to induction in the OR, or in an ICU immediately prior to the OR. Cardiology Reports Outpatient Clinic Chart 2030 VAD Device Data Implant Type Indicate the initial type of VAD implanted. RVAD Right Ventricular Assist Device LVAD Left Ventricular Assist Device BiVAD BiVentricular Assist Device 2040 VAD Product Type Indicate the specific product implanted. Implant defined as physical placement of the VAD. Select the type from the list on the collection form VAD Implant Date Indicate the date the VAD was implanted VAD Explant Indicate if the VAD was explanted. Explant is defined as physical removal of the VAD VAD Explant Date Indicate the date the VAD was explanted.

4 2080 VAD Explant Reason Indicate the reason the VAD was explanted Cardiac Transplant The VAD was explanted for Cardiac Transplant. Recovery The VAD was removed after cardiac recovery. Device Transfer The VAD was explanted in order to implant another assist device. Device Related Infection An infection within the pump pocket, driveline, VAD Endocarditis, or other infection requiring explantation of the VAD. The body of the VAD has an active infection requiring removal to eliminate the infection. Device related infections are defined as positive culture in the presence of leukocytosis, and/or fever requiring medical or surgical intervention. Device Malfunction The VAD pump itself is not functioning properly causing hemodynamic compromise, and/or requiring immediate intervention or VAD replacement 2090 VAD Cardiac Transplant 2100 VAD Cardiac Transplant Date 2110 VAD Initial VAD Cannulation/Attach Site LVAD Inflow Indicate whether the patient received a cardiac transplant during this hospitalization. Indicate the date the patient received a cardiac transplant. Indicate the location of the LVAD inflow site as the left atrium (LA) or the left ventricle (LV). The LVAD inflow is defined as the anatomic location (Left atrium or left ventricle) for the VAD cannula or conduit that provides the flow of blood from the heart to the VAD pump.

5 2120 VAD Initial VAD Cannulation/Attach Site RVAD Inflow Indicate the location of the RVAD inflow site as the right atrium (RA) or the right ventricle (RV). The RVAD inflow is defined as the anatomic location (right atrium or right ventricle) for the VAD cannula or conduit that provides the flow of blood from the heart to the VAD pump VAD Implant Type #2 Indicate the second type of ventricular assist device implanted. RVAD Right Ventricular Assist Device LVAD Left Ventricular Assist Device BiVAD BiVentricular Assist Device 2140 VAD Product Type # VAD Implant Date # VAD Explant # VAD Explant #2 Date Indicate the specific product #2 implanted. Implant defined as physical placement of the VAD. Select the type from the list on the collection form. Indicate the date the VAD #2 was implanted. Indicate if the VAD #2 was explanted. Explant is defined as physical removal of the VAD. Indicate the date VAD #2 was explanted.

6 2180 VAD Explant Reason #2 Indicate the reason the VAD #2 was explanted. Cardiac Transplant The VAD was explanted for Cardiac Transplant. Recovery The VAD was removed after cardiac recovery. Device Transfer The VAD was explanted in order to implant another assist device. Device Related Infection An infection within the pump pocket, driveline, VAD Endocarditis, or other infection requiring explantation of the VAD. The body of the VAD has an active infection requiring removal to eliminate the infection. Device related infections are defined as positive culture in the presence of leukocytosis, and/or fever requiring medical or surgical intervention. Device Malfunction The VAD pump itself is not functioning properly causing hemodynamic compromise, and/or requiring immediate intervention or VAD replacement. Operative Note Operative Record 2190 VAD Cardiac Transplant # VAD Cardiac Transplant Date # VAD Implant Type # VAD Product Type # VAD Implant Date #3 Indicate whether the patient received a cardiac transplant during this hospitalization. Indicate the date the patient received a cardiac transplant. Indicate the third type of ventricular assist device implanted. RVAD Right Ventricular Assist Device LVAD Left Ventricular Assist Device BiVAD BiVentricular Assist Device Indicate the specific product #3 implanted. Implant defined as physical placement of the VAD. Select the type from the list on the collection form. Indicate the date the VAD #3 was implanted.

7 2240 VAD Explant #3 Indicate if the VAD #3 was explanted. Explant is defined as physical removal of the VAD VAD Explant Date #3 Indicate the date VAD #3 was explanted VAD Explant Reason #3 Indicate the reason the VAD #3 was explanted. Cardiac Transplant The VAD was explanted for Cardiac Transplant. Recovery The VAD was removed after cardiac recovery. Device Transfer The VAD was explanted in order to implant another assist device. Device Related Infection An infection within the pump pocket, driveline, VAD Endocarditis, or other infection requiring explantation of the VAD. The body of the VAD has an active infection requiring removal to eliminate the infection. Device related infections are defined as positive culture in the presence of leukocytosis, and/or fever requiring medical or surgical intervention. Device Malfunction The VAD pump itself is not functioning properly causing hemodynamic compromise, and/or requiring immediate intervention or VAD replacement. Operative Note Operative Record 2270 VAD Cardiac Transplant # VAD Cardiac Transplant Date # VAD Primary VAD Intracranial Bleed Indicate whether the patient received a cardiac transplant during this hospitalization. Indicate the date the patient received a cardiac transplant. Indicate if the patient had an intracranial bleed, confirmed by CT scan or other diagnostic studies. CT Scan

8 2300 VAD Primary VAD Embolic Stroke Indicate if the patient had embolic stroke caused by a blood clot, air embolus, or tissue, confirmed by CT Scan or other diagnostic studies. CT Scan PhysicianProgress Notes Neurology Consult 2310 VAD Primary VAD Driveline and/or cannula Infection Indicate if the patient had a driveline and/or cannula infection. Driveline and/or cannula infection is defined as the presence of erythema, drainage, or purulence at the VAD connection site whether entering or exiting the body in association with leukocytosis and in the presence of positive cultures. Notes 2320 VAD Primary VAD Pump Pocket Infection 2330 VAD Primary VAD VAD Endocarditis 2340 VAD Primary VAD Device Malfunction 2350 VAD Discharge Status 11/4/03 Indicate if the patient had a pump pocket infection. A pump pocket infection is defined as a persistent drainage in the physical location of the pump, located preperitoneally or intra-abdominally with positive cultures from the pocket site. Indicate if the patient had VAD endocarditis. VAD endocarditis is defined as an infection of the blood contacting surface of the VAD device itself. This may include: Internal surfaces Graft material Inflow/Outflow valves of the VAD Indicate if the pump itself is not functioning properly causing hemodynamic compromise, and/or requiring immediate intervention or VAD replacement. Indicate the VAD status at discharge from the hospital. With VAD Without VAD Notes Notes Echo Report Notes