What Is an LVAD?
Unlike a total artificial heart, the LVAD doesn't replace the heart. It just helps it do its job. This can mean the difference between life and death for a person whose heart needs a rest after open-heart surgery, or for some patients waiting for a heart transplant (called "bridge to transplant").
LVADs may also be used as destination therapy, which is an alternative to transplant. Destination therapy is used for long-term support in some terminally ill patients whose condition makes them ineligible for heart transplantation.
How Does an LVAD Work?
Like the heart, the LVAD is a pump. The LVAD is surgically implanted just below the heart. One end is attached to the left ventricle -- that's the chamber of the heart that pumps blood out of the lungs and into the body. The other end is attached to the aorta, the body's main artery. Blood flows from the ventricles into the pump which passively fills up. When the sensors indicate it is full, the blood is ejected out of the device to the aorta.
The pump and its connections are implanted during open-heart surgery. A computer controller, a power pack, and a reserve power pack remain outside the body. Some models let a person wear these external units on a belt or harness outside.
The power pack has to be recharged at night.
What Are the Benefits of an LVAD?
An LVAD restores blood flow to a person whose heart has been weakened by heart disease. This helps relieve some symptoms such as being constantly tired or short of breath. And sometimes it lets the heart recover normal function by giving it a chance to rest (although this is rare). It maintains or improves other organ functions, improves exercise performance, and enables participation in cardiac rehabilitation.
What Are the Risks of Getting an LVAD?
As with any surgery, there are risks involved. Your surgeon will discuss the risks of the procedure with you.
After surgery, there are other risks, including:
- Internal bleeding
- Heart failure
- Device failure
- Blood clots
- Respiratory failure
- Kidney failure
In studies, therapy with the permanent LVAD device doubled the one-year survival rate of patients with end-stage heart failure as compared with drug treatment alone. However, there were some risks, including infection, stroke, and bleeding.
Talk to your doctor to find out if a LVAD is right for you.
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Reviewed by Robert J Bryg, MD on September 15, 2009