A left ventricular assist device (LVAD) or simply a ventricular assist device is a mechanical electronic device which is used as a pump for the heart. Mostly, LVAD is implanted when the heart's condition has been deteriorating that can potentially lead to heart failure. The LVAD is surgically implanted which is aids in lifting the left ventricle (main pumping chamber of the heart) pump blood to the rest of the body.
However, don't confuse LVAD for an artificial heart. The artificial heart replaces the failing heart whereas the LVAD instead of replacing the heart, assists it does its job. LVAD is a very good medical option for the patients who are too weak to get open heart surgery to treat heart disease or are in a long queue to get a heart transplant. Sometimes, a permanent LVAD is used for patients who are terminally ill and now their condition may not allow them to get extensive and complicated surgery such as a heart transplant. This kind of treatment is also called destination therapy.
• When a patient receives an LVAD while he is waiting for a heart transplant, it’s called Bridge to Transplant. The patient’s LVAD may provisionally aid in pumping blood till the time a heart donor becomes available for a heart transplant.
• In a situation where the patient may be declared ineligible for a heart transplant, an LVAD implant becomes the permanent solution. This is called Destination Therapy which has been becoming more common since the time LVAD's benefits are having a huge impact on lives on people who had a diseased heart before LVAD surgery.
• When an LVAD is implanted for temporary heart failure, the type of implant is called Bridge to Recovery. In some cases which are rare, a heart may recover its strength after being given time to relax by an LVAD implant for the time being.
If you are a patient who is seeking to get receive an LVAD implant, you may be having heart disease or progressive heart failure which can not be treated. The cardiologists implant an LVAD on the heart which is sick, but not too sick overall since that would make the LVAD implant surgery a little risky. To check if the heart is diseased enough, and if the rest of the body is in a decent position to receive an LVAD implant, the cardiologists might run a number of objective tests.The result of these objective tests will help the cardiologist and his team evaluate if getting an LVAD implant is a good fit for you, your heart and the body.
However, LVAD may not be a good choice of surgical treatment for heart disease if you have:
• blood clotting disorders
• irreversible kidney failure
• severe liver disease
• severe lung disease
• infections that cannot be treated with antibiotics.
For patients suffering from advanced heart failure, getting an LVAD implant may bring out benefits which are more than expected.
Some of the benefits of LVAD include:
• A better quality of life
• less fatigue
• more strength
• better breathing
• longer survival.
• improved functional capacity
An LVAD consists of:
• A pump that is attached to a ventricle inside the body
• An external controller, which is a small computer that monitors the pump
• A driveline cable, which connects the pump to the controller
• Power sources that run the pump and controller
Implanting an LVAD in the heart may take from four to six hours to complete. LVAD is a device which can pump blood just like like the heart. One of the ends of the LVAD is attached to the left ventricle of the heart which is the part or chamber of the heart responsible for pumping blood out of the lungs through the other parts of the body. The second end of the LVAD is attached to the aorta, which is the body's main and longest artery. The heart pumps blood from the left ventricle into the aorta through the aortic valve. A tube passes through the skin reaching to the device. The exterior of the tube is coated in a special material which helps in healing, allowing the regrowth of the skin. The pump and all its connections are implanted when the cardiologist makes incisions to conduct open-heart surgery. The other surgery equipments consist of a computer controller, a power pack, and a reserve power pack but they function outside the body and are not planted into the interior. Despite the small size of the LVAD, it is capable enough to pump blood every minute in order to curb the heart failure/disease symptoms. The cardiologist will regulate the LVAD pump so that there's an adequate flux of the blood to meet body needs. A connection between the driveline and the pump is made. The cable that connects the pump to the controller is fed through a small incision in your abdomen.
As with any surgery, there are risks involved. After the surgery, there are some LVAD risks ranging to mild to severe. These include:
• Internal bleeding
• Device problem
• Blood clots
Several studies show that surgery conducted to get a permanent LVAD device successfully doubles the one-year survival rate of patients with end-stage heart failure in comparison to patients sticking to drug treatment alone.