Table of ContentsView AllTable of ContentsHow Does It Work?TypesWho Are They For?BenefitsRisksPreparing for SurgeryDuring ProcedureAfter Getting an LVADRecovery
Table of ContentsView All
View All
Table of Contents
How Does It Work?
Types
Who Are They For?
Benefits
Risks
Preparing for Surgery
During Procedure
After Getting an LVAD
Recovery
A left ventricular assist device (LVAD) is a surgically implanted pump used in the treatment ofend-stage heart failure. It is a type of mechanical support device that helps provide blood flow when the heart is too weak to adequately meet the body’s needs.
LVADs may be recommended for people awaitingheart transplantor they can be implanted long term. While they are not a cure, they can improve survival and quality of life.
While some LVADs are meant only for temporary use in the hospital, this article will focus on durable LVADs, which are meant for long-term use. Read on to learn more about the different types of LVADs, how they work, benefits, complications, and what’s involved in LVAD surgery.
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How Does a Left Ventricular Assist Device Work?
LVADs are pumps that are inserted into the main chamber of the heart (theleftventricle)and connected with a tube to the large blood vessel leaving the heart (aorta) to provide blood flow to the body. Blood flows into the LVAD pump from the left ventricle and is pumped out through a tube into the aorta and to the rest of the body.
Types of LVADs
“Left ventricular assist device”is a broad term for anymechanical support deviceplaced in the left ventricle to help pump blood. Certain types of LVADs are only meant to be used temporarily while in the hospital. These are implanted in the groin and connected to a large machine outside the body.
Temporary LVADs like these are designed to be in place for up to 10 days to a month, depending on the specific device. A person cannot leave the hospital with one of these devices in place.
Durable LVADs, however, are designed to be portable and can be used at home. Durable LVADs may be implanted for people awaiting a heart transplant, a strategy known as “bridge-to-transplant,” or they may be implanted long-term without a plan for transplant to improve survival and quality of life.
Durable LVADs were first approved in the 1990s, and since then, there has been great technological innovation in these devices. LVADs nowadays are smaller and use magnets to provide continuous flow while reducing friction and risk of blood clots. These can remain in place for many years. The two available devices are the HeartMate III and HeartWare.
Your advanced heart failure team will help determine the right device and strategy for you.
Who Are LVADs For?
LVADs are for treatment ofadvanced heart failure. People who may get an LVAD may have:
There are other considerations, such as the size of the left ventricle and the ability of the patient to perform dressing changes and care for the device, in addition to whether they takeblood thinners. A multidisciplinary team of heart failure specialists, cardiac surgeons, social workers, and other clinicians helps determine whether the therapy has a good chance of success.
What Are the Benefits of an LVAD?
LVADs also improve survival, allowing people to live for many yearsbeyond what is expectedwith their condition, and often allow them additional time in which to receive a heart transplant.
How Long Can Someone Live With an LVAD?Survival rates depend on many factors, including the type of device, need for treatment, and the type of strategy (bridge-to-transplant vs. destination therapy), but for current generation LVADs, studies have determined survival rates as follows:One-year survival rate of about 84%Four-year survival rate of about 50%These numbers have improved with advancements in LVAD technology and heart failure therapy. Some people are still alive 15 years after LVAD placement.This is compared to an approximate two-year survival rate of 50% in people with advanced heart failure who do not receive an LVAD or heart transplant.
How Long Can Someone Live With an LVAD?
Survival rates depend on many factors, including the type of device, need for treatment, and the type of strategy (bridge-to-transplant vs. destination therapy), but for current generation LVADs, studies have determined survival rates as follows:One-year survival rate of about 84%Four-year survival rate of about 50%These numbers have improved with advancements in LVAD technology and heart failure therapy. Some people are still alive 15 years after LVAD placement.This is compared to an approximate two-year survival rate of 50% in people with advanced heart failure who do not receive an LVAD or heart transplant.
Survival rates depend on many factors, including the type of device, need for treatment, and the type of strategy (bridge-to-transplant vs. destination therapy), but for current generation LVADs, studies have determined survival rates as follows:
These numbers have improved with advancements in LVAD technology and heart failure therapy. Some people are still alive 15 years after LVAD placement.This is compared to an approximate two-year survival rate of 50% in people with advanced heart failure who do not receive an LVAD or heart transplant.
What Are the Risks of Getting an LVAD?
While LVADs can improve survival and quality of life, there are several risks to know about. LVADs carry a risk of the following complications:
When to Contact a Healthcare Provider About ComplicationsYour advanced heart failure team will follow you closely after LVAD implantation. It’s important to discuss any concerns regarding your LVAD with your team. Talk with your healthcare provider if you have any concerning symptoms, or develop any of the following:Signs of infection, such as fever, redness, pain, or bleeding around the driveline siteChest painShortness of breathSwellingNeurological signs such as weakness, facial droop, difficulty speaking, or confusion
When to Contact a Healthcare Provider About Complications
Your advanced heart failure team will follow you closely after LVAD implantation. It’s important to discuss any concerns regarding your LVAD with your team. Talk with your healthcare provider if you have any concerning symptoms, or develop any of the following:Signs of infection, such as fever, redness, pain, or bleeding around the driveline siteChest painShortness of breathSwellingNeurological signs such as weakness, facial droop, difficulty speaking, or confusion
Your advanced heart failure team will follow you closely after LVAD implantation. It’s important to discuss any concerns regarding your LVAD with your team. Talk with your healthcare provider if you have any concerning symptoms, or develop any of the following:
How to Prepare for LVAD Surgery
If yourcardiologistrecommends placement of an LVAD, you will meet with many people to discuss what to expect with an LVAD. Getting an LVAD is life-changing. It can improve symptoms drastically but also requires being connected to a machine that requires special care and attention, taking medication like blood thinners, and caring for a surgical site.
You might think of it as trading one disease (advanced heart failure) for another condition that requires frequent visits to healthcare providers, medications, and specialized care.
Members of a specialized team will meet with you and any family members or caregivers who may be involved in helping you recover and care for an LVAD.Deciding to get an LVAD is not a decision that is made overnight, and you will be given a lot of education about LVADs and how to care for them and yourself before surgery.
What Happens During an LVAD Procedure?
LVAD surgery is a major open-heart surgery that requires a cardiac surgeon to cut open the chest to implant the device. You will be given general anesthesia so that you are sleeping and do not feel pain during the procedure. You will be placed on a ventilator (breathing machine) for the surgery.
What Happens After Getting an LVAD?
After getting an LVAD, you will receive care in a specialized intensive care unit and you can expect to stay in the hospital for a couple of weeks while you recover. You will be connected to many wires and tubes.
A breathing machine will remain in place for some time, This can range from as little as six to eight hours after surgery to much longer, depending on your breathing status. Medications and fluids will be given to help stabilize your blood pressure. Your heart rhythm, vital signs, and urine output will be closely monitored.
Heart surgery takes a toll on the body andphysical and occupational therapistswill work with you to help you regain strength and teach you how to maneuver with the LVAD. Throughout your hospitalization, you will continue to receive training about caring for your LVAD and the incision site. By the time you are ready to leave the hospital, you and any caregivers involved are comfortable managing the device.
How Long is Recovery After Receiving an LVAD?
Recovery after LVAD implantation can take several weeks. It is not only a major heart surgery, but the initial recovery time in the intensive care unit can lead to deconditioning of (a loss in fitness in) your muscles. You can expect to spend at least a few weeks in the hospital, during which time you will work with physical therapists as you regain strength and work on mobility. You may also participate in acardiac rehabprogram with exercise prescription and counseling.
Summary
LVADs are a type of surgically implanted heart pump for certain people with end-stage heart failure. With durable, or long-term LVADs, a small pump placed in the heart connects to a portable electric controller and battery pack that must be worn at all times.
Durable LVADs aren’t a cure, but they improve symptoms, quality of life, and survival in people with advanced heart failure. They require special care and follow-up care with an advanced heart failure specialist, who will ensure appropriate functioning of the device and monitor for complications like infection, bleeding, and blood clots.
11 Sources
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Ben Gal T, Ben Avraham B, Milicic D, et al.Guidance on the management of left ventricular assist device (LVAD) supported patients for the non-LVAD specialist healthcare provider: executive summary.Eur J Heart Fail. 2021;23(10):1597-1609. doi:10.1002/ejhf.2327
American Heart Association.Implantable medical devices.
Miller L, Birks E, Guglin M, Lamba H, Frazier OH.Use of ventricular assist devices and heart transplantation for advanced heart failure.Circ Res. 2019;124(11):1658-1678. doi:10.1161/CIRCRESAHA.119.313574
Berardi C, Bravo CA, Li S, et al.The history of durable left ventricular assist devices and comparison of outcomes: HeartWare, HeartMate II, HeartMate 3, and the future of mechanical circulatory support.J Clin Med. 2022;11(7):2022. Published 2022 Apr 5. doi:10.3390/jcm11072022
Chaudhry SP, DeVore AD, Vidula H, et al.Left ventricular assist devices: A primer for the general cardiologist.J Am Heart Assoc. 2022;11(24):e027251. doi:10.1161/JAHA.122.027251
Guglin M, Zucker MJ, Borlaug BA, et al.Evaluation for heart transplantation and LVAD implantation: JACC Council perspectives.J Am Coll Cardiol. 2020;75(12):1471-1487. doi:10.1016/j.jacc.2020.01.034
Abbot.The Traveling Sisterhood of the HeartMate LVAD.
Whitson BA.Surgical implant techniques of left ventricular assist devices: an overview of acute and durable devices.J Thorac Dis. 2015;7(12):2097-2101. doi:10.3978/j.issn.2072-1439.2015.11.53
American Heart Association.What happens after heart surgery?
Shaaban A, Schultz J, Leonard J, et al.Outcomes of patients referred for cardiac rehabilitation after left ventricular assist device implantation.ASAIO J. 2023;69(3):304-308. doi:10.1097/MAT.0000000000001799
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