Ventricular Assist devices are mechanical devices that may be implanted through open heart surgery. Although the surgery is risky, the devices can save the life of the recipient if they have severe heart failure. These devices may be used as temporary assistance before a heart transplant or as a permanent solution to help your heart sustain blood flow. Current technologies of LVADs allow a continuous flow of blood from your heart and are called continuous flow devices.
No, it is simply a device that assists your heart. When the left ventricle contracts, the device assists in the contraction by pumping along with the patient’s heart.
There are several kinds of LVAD devices, each with its variations. An LVAD is composed of multiple parts.
A pump unit is implanted in the apex of the heart, where it receives blood. It then continuously pumps this blood through a tube-based connection to the aorta. The pump is connected to a driveline or a wire that passes out through the skin into the belly, where a control unit is placed. The controller is responsible for running the pump and gives feedback allowing the recipient to operate the system better. A power supply - usually in the form of rechargeable batteries runs the system.
Your doctor will recommend a VAD only after considering multiple factors like:
LVADs aid in circulation and help in improving the functioning of other organs in your body. This helps recover functions of the kidneys, liver, brain, etc., and allows you to participate in more activities, including rehabilitation exercises to further strengthen your heart.
LVAD is suggested as destination therapy, but that does not mean that it cures the condition. Since it is a newer technology, real-world data is not available to the life of the devices. The pumps may need replacement if they get damaged or start malfunctioning. However, the benefits outweigh the risks for someone with severe heart failure who is unable to or unlikely to receive a transplant.
Yes. As soon as your condition stabilizes and your doctors are convinced that you are strong enough to handle day-to-day tasks and no other problems will occur, you will be sent home. You will be advised on how to maintain the device, keep it charged and operate it. You will also be told how you can handle different activities and the warning signs to look out for, and alert your doctor. You may have to monitor your weight, temperature, and blood pressure regularly once you go home.
A VAD requires surgery to be implanted. Your doctor will evaluate your fitness for surgery and receive anaesthesia. You may be asked to get admitted to the hospital a few days before to prepare you for the surgery.
You may be asked to get some tests done to evaluate your condition which may include. Some of these tests may be repeated when you get admitted for surgery as well:
The procedure usually takes between three to four hours. The device is inserted using open heart surgery. You will receive medications that put you in deep sleep. During the surgery, you will be connected to a ventilator to assist with the oxygenation of your body. If your heart is going to be stopped for the procedure, you may be connected to a device known as a heart-lung machine.
You can read more about open heart surgery in our article here.
You will be required to stay in the Cardiac ICU for a few days when the team can monitor your progress and how your body is responding to the treatment. They can also watch out for risks associated with the procedure and ensure immediate intervention if it becomes necessary.
The number of days in the ICU depends on your health and whether complications develop. After this, you will be sent to a hospital room, where the team will assist you with the process of recovery and help you become more self-sufficient. They will also educate you on how to maintain and use the device properly and on vitals like blood pressure, temperature, and body weight that you may need to keep a track of. The number of days you stay in the hospital depends mostly on your state of health before and after the procedure.
You will be taught:
You will need follow-up visits after you receive a VAD to ensure you and the device are performing well. However, the frequency of visits needed will taper off to monthly visits. After the first year, the frequency of visits will come down more. You may also need to visit again if you are awaiting a heart transplant. Your doctor may also recommend cardiac rehabilitation programs for your heart health.