Ahmet Rüçhan AKAR, Şeref Alp KÜÇÜKER, R GÖKÇEN ORHAN, Sanem NALBANTGİL, Tahir YAĞDI, Mustafa ÖZBARAN, Ali GÜRBÜZ, Lale TOKGÖZOĞLU, Mehmet EREN, Ahmet EKMEKÇİ, Leyla Elif SADE, Mehmet Birhan YILMAZ

İleri evre kalp yetersizliği ve mekanik destek cihazlarının geleceği: Kardiyoloji ve Kalp Damar Cerrahisi Uzlaşı Raporu

Kalp yetersizliği ilerleyici bir hastalıktır. Tanı, tedavi ve takibindeki tüm gelişmelere ve hastalık sürecini yavaşlatabilen alternatiflere rağmen, hastaların önemli bir kısmı er ya da geç ileri evre ya da terminal evreye ulaşır. Terminal evredeki hastanın palyatif bakımının yanı sıra ileri evre hastanın dikkatli tanınması, bu hastalara yönelik tedavi seçeneklerinin göz önüne alınması bakımından hayati derecede önemlidir. Kalp yetersizliği hastalarının tedavi ve bakımı, genel açıdan pek çok disiplinin bir arada çalışmasını zorunlu kılmaktadır. Bununla birlikte, ileri evre kalp yetersizliği hastaları; kardiyoloji uzmanları, kalp damar cerrahisi uzmanları ve bu hastaların bakımından sorumlu diğer tıbbi personel arasında çok yakın iletişim ve iş birliğini gerektirmesi nedeniyle, kılavuz önerileri doğrultusunda, "kalp ekibi" tarafından ele alınmalıdır. Ülkemiz, ileri evre kalp yetersizliğinin yönetimi konusunda deneyim sahibi hekimlere sahiptir. Ancak, merkezlerin dağılımı, hastaların tedavi seçeneğine eşit derecede ulaşımı konularında yeterli olduğumuz söylenemez. Bu nedenle, uygun aday hastanın sevki ve hasta dolaşımı konularında daha kat edecek yolumuz bulunmaktadır. Bu uzlaşı raporu; ileri evre kalp yetersizliği yönetiminde deneyimli ve sertifikasyona sahip merkezler ile evresinden bağımsız olarak kalp yetersizliği hastalarının takip ve tedavisinin düzenlendiği merkezler ve diğer sağlık personeli arasındaki bağı güçlendirmek, farkındalığı artırmak ve ülkemiz koşullarına ilişkin güncel bilgi sağlamak amacıyla hazırlanmıştır.

Advanced heart failure and future of mechanical assist devices: a Consensus Report on Cardiology and Cardiovascular Surgery

Heart failure is a progressive disease. A considerable portion of patients reach an advanced or terminal phase later or sooner, despite all of the developments in diagnosis, management, and follow-up and alternatives which can slow the disease process. As well as the palliative care of the patient in the terminal phase, definite recognition of the patient with advanced disease is vital for the consideration of therapeutic options in this patient population. Overall management and care of patients with heart failure obligates a collaboration of multiple disciplines. In addition, patients with advanced heart failure should be managed by a "heart team", as indicated by the guideline recommendations, since it requires a close communication and collaboration among cardiologists, cardiovascular surgeons, and other medical staff who are responsible for taking care of these patients. In Turkey, we have experienced physicians for managing patients with advanced heart failure. However, we are unlikely to be sufficient in the distribution of the centers and equal accessibility for all patients to therapeutic options. Hence, we still have more to do for the referral of eligible patients and patient circulation issues. This consensus report is developed to strengthen the connection between experienced and certified centers and the centers which take care of heart failure patients independent of the disease phase and other healthcare staff to increase awareness and to provide updated information for the current conditions of Turkey.

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