• LVAD
• disconnection
• out-of-hospital
• ventricular assist device
• VAD
• cardiac care
• heart failure
• major incidents
• nursing
• prehospital
• resuscitation

The case of a 63-year-old Caucasian male suffering from secondary dilatative cardiomyopathy due to ischaemic and consecutive valvular heart disease was reported. He had had bypass surgery and mitral valve replacement in 2002 after mitral chord rupture. Five years later, several episodes of arrhythmias occurred (recurrent atrial fibrillation and ventricular tachycardia) and his cardiac function decreased. Echocardiographic examination revealed an ejection fraction of 25% and, subsequently, he was listed for cardiac transplantation. Despite extensive conservative treatment, the patient developed end-stage heart failure and a biventricular ventricular assist device (VAD) (EXCOR VAD ®, Berlin Heart AG, Berlin, Germany, figure 1) was implanted at the end of 2007. The patient recovered from this operation without any complications and was discharged home after receiving specific instruction for VAD management. Regular assessments and controls were performed at the hospital on an outpatient basis.