Left Ventricular Assisted Device (LVAD)- To Tackle End-Stage Heart Failure

Cardiac Surgery | by Dr. Manoj Kumar Daga | Published on 15/10/2021

Our body requires blood and oxygen to carry out a variety of functions. Heart failure can result in a weakening of the heart muscles that cause insufficient pumping of the oxygen-rich blood throughout the body. As a result, the person with a failing heart would experience symptoms like excessive fatigue, shortness of breath, a rapidly beating heart, and swollen legs. This can result in decreased quality of the health, life and lead to poor performance at work.

One of the ways to restore a healthy heart rhythm and allow for better life quality is Left Ventricular Assisted Device (LVAD) surgery that can take over the pumping function of the heart. 

What is an LVAD?

The left ventricle located in the bottom left chamber of the heart is responsible for pumping oxygen-rich blood to different parts of the body. An LVAD (Left Ventricular Assisted Device) is a battery-operated, mechanical circulatory support that can help the weakened left ventricle pump oxygen-rich blood to the rest of the body via the aorta. It can be implanted as a short-term solution for heart pumping while the person is waiting for a heart transplant (called bridge-to-transplant) or be used temporarily while the heart heals after surgery. This mechanical pump can also be used as a long-term fix for a failing heart when the transplant is not a suitable option (known as destination therapy).

How does LVAD work?

Different types of LVAD are performed and chosen based on the patient's needs and medical condition by the best heart doctor in Kolkata:

Although all these types may vary in their parts, an LVAD is made up of four parts:

• A pump: It is placed in the chest by the surgeon during open-heart surgery at the apex of the heart to receive blood and deliver it to the aorta (the largest artery that passed blood to the rest of the body from the heart).  
• A driveline (cable): It includes many electric wires that pass from the LVAD device through the skin on the abdomen to the system controller. It transmits electric signals to an LVAD device to keep it working.
• A control system (controller): It is placed outside the body and sends messages or alarms to help operate the system and allow it to run the pump efficiently.
• A power supply: It includes rechargeable batteries or a cord that can be plugged into an electrical socket to provide power for the running of LVAD. 

LVAD surgery:

Traditional open-heart surgery is performed under general anaesthesia to implant an LVAD. During the procedure, the cardiac surgeon makes a long deep cut in the middle of the chest to open the sternum (chest bone) and gain access to the heart to place LVAD. In some cases, the incision may be made on the left side of the chest (a process called Thoracotomy).

To place LVAD, the patient may be put on a heart-lung bypass machine to allow the supply of oxygen-rich blood throughout the body. A ventilator may be used to assist the patient to breathe during surgery. Soon after the LVAD is positioned in its right place, the incision is closed with sutures.

The recovery from the surgery and the time for hospital stay vary for every patient. Generally, 14-21 days of hospital stay after LVAD surgery is advised. Multiple follow-up visits may be needed to ensure the proper working of LVAD and the improvement in the patient’s overall health.

What are the benefits of LVAD?

After implanting an LVAD in patients with end-stage heart failure, the blood flow to the entire body is significantly improved. As a result, the functioning of other vital organs like lungs, kidneys, liver, brain, and others are improved which in turn allows patients to regain their strength. This makes the patients capable to participate in different physical activities including cardiac rehabilitation that were not possible before having an LVAD implant.

It has been proven and reported that patients with heart failure who are treated with LVAD surgery have greater life expectancy than those who have undergone only medical therapies.

With LVAD surgery, the patients no longer experience symptoms of heart failure like fatigue, shortness of breath, and excess fluid accumulation. Hence, they can avoid hospitalization for heart failure and return to routine activities with better performance.

To know more about Left Ventricular Assisted Device surgery, schedule an appointment now with the expert heart doctors at BM Birla Heart Research Centre, best cardiac centre in Kolkata.