What is Left Ventricular Assist Device (LVAD)?
A ventricular assist device (VAD), also known as a mechanical circulatory support device, is an implantable mechanical pump that assists in the pumping of blood from your heart's lower chambers (ventricles) to the rest of your body. In those with weakening hearts or heart failure, a VAD is used.
Although a VAD can be implanted in your heart's left, right, or both ventricles, it is most commonly used in the left. A left ventricular assist device is one that is implanted in the left ventricle (LVAD), and serves as a partial artificial heart.
The device can be used for short, intermediate, or long-term- typically to treat advanced heart failure.
While you wait for a heart transplant or for your heart to become strong enough to pump blood on its own, you may have a VAD implanted. If you have heart failure and are not a suitable candidate for a heart transplant, your doctor may propose that you have a VAD implanted as a long-term treatment.
The LVAD is placed by performing an open heart surgery. The components of an LVAD vary depending on the device type, but there are four core components:
In the chest, the pump unit is installed. The surgeon places it at the apex of the heart, where it gets blood. This blood is then sent to the aorta (the main artery that carries blood from the heart to the rest of the body) via a tube. It pumps blood from the left ventricle to the aorta continuously.
A driveline (cable) and a control system are connected to the pump (controller). The driveline connects the device to the controller (a small computer) on the outside of your body through the skin on your belly (abdomen). The controller controls the pump and displays messages and alarms to aid in system operation.
The LVAD is powered by a power supply (rechargeable batteries or a wire that fits into an electrical outlet).
When is LVAD required?
Your doctor may recommend that you have a VAD implanted if:
You are waiting for a heart transplant : While you wait for a donor heart to become available, you may have a VAD installed temporarily. A VAD can keep blood flowing even if your heart is damaged, and it will be removed once your new heart is placed. It may also assist to enhance the performance of other organs in your body that aren't operating properly, as well as other medical issues. A "bridge to transplant" is a VAD that is installed while you are waiting for a heart transplant.
Because of your age or other medical issues, you are currently ineligible for a heart transplant : People with heart failure who aren't ideal candidates for a heart transplant are increasingly using VADs as a long-term treatment. If you're over the age of 65, you might not be eligible for a heart transplant. In that case, the VAD would be implanted as a heart failure treatment. A VAD can help you live a better life.
Your heart's function can become normal again : If your heart failure is only temporary, your doctor may recommend a VAD to keep your heart strong enough to pump blood on its own. The term "bridge to recovery" is used to describe this situation.
It's also feasible that a VAD will be placed for a brief period of time during or after heart surgery. For a few weeks or months, you may have a VAD installed.
How is LVAD done?
Open heart surgery is needed to implant an LVAD. The surgery is done under general anesthesia and you will be asleep the entire time. The procedure lasts 4-6 hours.
Step 1
The surgeon makes a long incision on the breastbone and accesses the heart by spreading the rib cage.
Step 2
The surgeon connects one end of the LVAD tube to the heart's left ventricle and a tube exiting the other end of the external LVAD to the aorta.
Step 3
A small electrical cord connected to the LVAD (a driveline) exits from the upper abdomen and is connected to a power supply (either batteries or a plug-in) and a small computer to operate the device.
Once the device is working properly, the patient is taken off cardiopulmonary bypass and the chest is closed with stitches.
What is the Recovery after LVAD like?
Patients with an LVAD must carefully follow the guidelines given by their cardiac surgeon in order to improve their quality of life. Your ability to return home will be determined by your rate of recovery and medical condition.
Following surgery, cardiac rehabilitation is a vital program to participate in. Some activities, such as swimming, contact sports, and weight lifting, may be prohibited. Before and after the LVAD implant operation, it's critical to maintain healthy lifestyle adjustments.
What Results Can I Expect from LVAD?
The LVAD improves the function of the kidneys, liver, brain, and other organs by increasing blood flow to the body; it also improves the patient's strength and ability to participate in activities like cardiac rehabilitation by increasing blood flow to the body. The benefits of LVAD include:
Greater life expectancy: Patients with severe heart failure who receive an LVAD live longer than those who receive only medical treatment.
Better quality of life: Patients with severe heart failure can use an LVAD to participate in activities that were previously impossible.
Fewer symptoms of heart failure: Shortness of breath, excess fluid, and weariness are all signs of heart failure that an LVAD can help with. This allows patients to feel better and participate in everyday activities, avoiding heart failure hospitalization.
