Left ventricular assist device (LVAD): What you should know

A surgeon instals a heart pump called a left ventricular assist system (LVAD) to help treat heart failure. This system helps maintain adequate blood flow and avoid complications when the left ventricle of the heart is unable to pump blood efficiently.

The majority of people who are candidates for LVAD implantation have:

Any of these can cause serious heart damage, and an LVAD can aid by directing oxygenated blood from the heart’s left ventricle to the aorta. The blood is then distributed across the body by the aorta.

However, having an LVAD implanted is major surgery with certain risks. Continue reading to learn more about these machines, the insertion process, and recovery times.

Definition

Left ventricular assist device (LVAD) implantation

An LVAD is a system that aids in the pumping of blood by the left side of the heart. A surgeon applies an LVAD to the heart of a patient with heart failure to help facilitate blood flow.

In the meantime, a person who is waiting for a heart transplant can benefit greatly from getting an LVAD. Receiving an LVAD is a “destination” procedure for those people who want to improve the function of their heart and other vital organs.

How does it function?

An LVAD pumps blood from the left ventricle of the heart to the aorta through a tube connected to a pump. This tube transports blood from the heart to the arteries in the body.

A power source and a control unit are also included in the device, allowing the user to monitor how well their LVAD is functioning.

Learn how the heart pumps blood here.

Who needs one?

Since the system needs major surgery to implant, a doctor can only prescribe an LVAD to people with heart failure if they meet the following criteria:

  • Before a transplant: An LVAD will help someone who is waiting for a heart transplant, and it is referred to as a “bridge to a transplant” in this situation.
  • To treat severe heart failure: If a transplant isn’t possible or the patient doesn’t meet the criteria, the LVAD may be the best option. In this case, the doctor may refer to it as “destination therapy.”
  • If heart failure is temporary: An LVAD can be beneficial only when a human faith is healthy enough to restore normal operation, so in that case the system is referred to as a “bridge to recovery.”

The procedure

An LVAD needs open-heart surgery to be implanted. The patient is given a general anaesthetic as well as anti-clotting medication.

The surgeon places the pump in the upper part of the stomach wall during the operation. The heart is connected to the pump through a tube. During surgery, the medical staff usually uses drugs to stop the heart. They use a heart-lung bypass machine in this case to keep oxygenated blood circulating across the body.

The LVAD implantation procedure takes 4–8 hours, during which the patient is awakened and the healing process begins.

Recovery

People spend the first 3–5 days of their recovery in an intensive care unit. They are transferred to a more general ward of the hospital for a period of two to three weeks. A cardiac rehabilitation programme, which aims to strengthen the heart through exercise and health education, may also be needed.

During the healing time, doctors keep a close eye out for signs of infection. They can protect themselves from infection by:

  • keeping a good hygiene
  • administering any vaccines that may be required
  • the LVAD and the insertion site should both be cleaned

If a person finds that their LVAD is malfunctioning after leaving the hospital, they should seek medical attention right away to avoid complications.

Aims

By lowering the risks associated with heart disease, an LVAD can dramatically boost a person’s outlook.

After surgery, a person can continue to take blood thinners and aspirin for the rest of their lives. They should, however, resume daily activities such as:

  • traveling
  • driving
  • working
  • exercising

A person can shower with a shower bag over the device, but they cannot go swimming. This is to avoid making the system wet.

Researchers are experimenting with various methods of implanting the system in order to reduce the amount of damage to everyday life following the procedure.

Benefits

The efficiency with which the heart pumps and how well other organs, such as the kidneys, perform can both be improved with an LVAD.

Furthermore, it has the potential to increase survival rates in people with heart failure, who may:

  • be able to walk longer distances
  • have an overall improved quality of life 1 year after the procedure
  • have an overall improved emotional state 1 year after the procedure

Complications

An LVAD implantation, like any big surgery, comes with risks. The following are some of the possible complications:

  • bleeding of the gut or brain
  • clotting
  • stroke
  • an infection
  • dysfunction of the heart’s right side
  • hemolysis, or rupture of red blood cells

If an infection occurs, the system can need to be removed, which can be dangerous.

It is important to weigh the costs and benefits and have a detailed discussion with the medical team. Following the surgery, it is important to closely follow the doctors’ orders.

Compared with a pacemaker

A pacemaker and an LVAD serve different functions. While an LVAD aids in the efficient pumping of blood, a pacemaker aids in the correction of an irregular or sluggish heartbeat. A pacemaker does not assist with pumping; rather, it induces electrical stimulation that controls the heartbeat.

A pacemaker often necessitates less invasive and complicated surgery. The battery-operated gadget sits under the skin of the chest.

Finally, while an LVAD may be a temporary solution while a person waits for a transplant, pacemakers are typically permanent treatments.

Conclusion

An LVAD is a system that aids the heart in efficiently pumping oxygenated blood. The system involves open-heart surgery, which physicians only prescribe in some situations for people with heart failure.

Anyone who has obtained an LVAD should closely follow their doctors’ instructions due to the possibility of life-threatening complications.

Many people can resume normal daily activities after recovering from surgery, such as working, travelling, and exercising that does not involve swimming.

Sources

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