Heart failure can progress to a point where it becomes end-stage heart failure. At this time, your heart becomes so weak it needs mechanical assistance to help do its job.
Our expert surgeons can give your heart a boost by implanting a pump called a left ventricular assist device, or LVAD. This device helps your heart pump blood to the rest of the body.
What is a Left Ventricular Assist Device (LVAD)?
A left ventricular assist device is a small pump that helps circulate your blood when your heart becomes too weak to do its job effectively. The pump enables your heart to pump more blood with less work. An LVAD does not replace your heart and is not an artificial heart.
An LVAD is surgically attached to your left ventricle, your heart’s bottom left chamber. The pump continuously moves oxygen-rich blood from the left ventricle into the aorta, where it is delivered to the rest of your organs.
A left ventricular assist device consists of several parts:
- Pump: Resides inside or near your chest, and is attached to your heart.
- Driveline: A small cable that attaches the pump to an external controller. The driveline exits your body through the skin.
- Controller: A small computer, this machine alerts you when batteries need to be changed or if your device requires other attention. The controller usually is worn in a pack around the waist.
- Batteries: Your LVAD needs an electrical source at all times, so it is usually attached to rechargeable batteries.
- Power plug: You usually connect to an electrical source to recharge batteries.
When will your doctor recommend a LVAD?
Your doctor may recommend a left ventricular assist device when medications are no longer enough to help your heart pump adequate amounts of blood to the rest of your body.
LVADs can be used in two different situations:
- Bridge-to-transplant: For patients who are awaiting a heart transplant, an LVAD can serve as a temporary assistive therapy until a suitable donor heart becomes available.
- Destination therapy: For patients who do not qualify for a heart transplant, or simply do not want one, an LVAD can be implanted as a long-lasting treatment. The pumps are designed to last for many years.
Left Ventricular Assist Device Surgery: Steps
LVADs are implanted through open-heart surgery. Your LVAD journey begins with expert doctors and a multidisciplinary team to support you through each stage of the process. There are several possible steps:
- Initial evaluation: To help make sure you will benefit from receiving an LVAD, we perform a thorough medical and psychosocial evaluation, including blood tests, imaging studies and meetings with several members of the team.
- Pre-surgical consultations: Before receiving a pump, you will meet with an LVAD coordinator who will educate you about how your LVAD works and answer your questions about the technology. You also will meet with a social worker to help you identify your social support systems and discuss what it is like to live with an LVAD. A financial counselor will meet with you to coordinate your insurance benefits and talk about the ongoing expenses of maintaining a left ventricular assist device.
- Surgery day: The open-heart surgery performed to implant an LVAD takes about four to six hours.
- Post-surgical recovery: After surgery, you will wake up in a cardiac intensive care unit. Our nurses have special training and expertise in caring for LVAD patients. Our expert cardiac intensivist physicians and their team will closely monitor you and oversee your care, in close collaboration with the surgeon and advanced heart failure cardiologist.
- Progressive Care unit: When you no longer need intensive care, you will be transferred to a specialized heart failure unit. As you continue to recover from surgery, you will learn how to get around with your LVAD and take care of it before being discharged.
- Going home: You may have many questions about living with your new left ventricular assist device. Your personal LVAD coordinator can talk you through these issues.
- Follow-up: We will follow you closely after surgery to help you stay safe and healthy. At first, you will see our team in clinic on a weekly basis. These visits will gradually become less frequent as you continue to improve.
Life with a Left Ventricular Assist Device (LVAD)
After the LVAD is implanted, it is our hope that patients resume an active lifestyle.
Receiving an LVAD may make you feel more energetic because your body is receiving an adequate amount of oxygen-rich blood again. You should be able to enjoy:
- Moderate exercise
- Intimacy with your partner
- Returning to work or school
Activities you may need to avoid include:
- Bathing in a tub or swimming: Your LVAD controller cannot be submerged in water. Your LVAD coordinator will help teach you how to adjust your personal hygiene.
- Contact sports: These activities could damage your device.
- Sleeping on your stomach: You will need to sleep on your back or side to avoid damaging any of the lines attached to the pump.
- Having an MRI scan: It is safe to undergo a CT scan or X-ray, but not an MRI.
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