Cardiac Surgery | by Dr. Manoj Kumar Daga | Published on 10/08/2021
LVAD stands for left ventricular assist device. It is a mechanical pump that is implanted in patients with heart failure. Also known as a mechanical circulatory support device, it helps the left ventricle to pump blood to the aorta and then the rest of your body. The device got its name owing to the fact that it is most commonly implanted in the bottom left chamber of the heart. Despite what the name suggests, experts specializing in LVAD surgery suggest that it can be placed in the left, right or both ventricles of your heart.
A left ventricular assist device cannot replace the heart and it only helps to pump blood when the heart is unable to do so on its own. It is usually implanted for a short period of time, depending upon the situation. For instance, patients waiting for a heart transplant surgery may require it till they get a donor, or when the doctors are waiting for the heart to become strong enough to pump blood on its own. Though it can also be used as a long-term solution for patients that have had heart failure and are not good candidates for heart transplant surgery.
The procedure involved in LVAD implantation, though offered at all the best heart hospitals in Kolkata, is fairly complex as it requires open-heart surgery. And just like any surgery, it has various risks associated with it. Hence, the procedure is only performed by highly specialized experts. Though the benefits of the surgery usually outnumber the risks, you cannot simply overlook the latter. Here are a few risks associated with LVAD surgery that you need to learn about:
Because it is open-heart surgery, the chances of bleeding during and after surgery are pretty high. And therefore it is advised to inform your doctor about all the medication that you are or has been taking. Patients who are on blood-thinning medication may be required to refrain from using the same till the procedure is done.
The device comes with a power source and a control unit which are located outside the body and are connected with a port in the skin. This increases the chances of germs getting in the port, which can cause an infection. Therefore you should be on the lookout for any signs of infection and inform your doctor about the same. Redness or soreness near the port, fluid draining from the site, or fever are typical signs of infection and should not be ignored.
It’s very common for blood clots to form as the blood moves through LVAD, and as blood clots can slow down or completely block the blood flow through the heart, it is quite likely that they can even cause the device to stop working. This can also elevate the risks of stroke or a heart attack. It is due to this very reason that blood-thinning medications are prescribed after LVAD implantation surgery. And it is also advised to have regular blood tests to monitor whether the blood-thinning medication is working or not. Medications, like warfarin and aspirin, are administered to help prevent blood clots after LVAD is implanted. One should be very careful while taking these medications as they have several side effects. These should only be taken when prescribed by the doctor.
Right heart failure is one of the most common risks that are associated with LVAD. What happens when one gets an LVAD implant is that more blood is pumped from the left ventricle and the right ventricle is not able to keep up with the increased amount, since it is not used to pumping as much blood. Medication and therapy can be used to improve the pumping ability of the right ventricle. In case, the medication and therapy are not succeeding, an RVAD is implanted to support the right ventricle.
At the end of the day, an LVAD is a machine and like any other machine, it can malfunction after being implanted. There can be a problem with the pumping action of the device, or the power supply can also cause some issues. Anyhow, if the device stops working, one should immediately seek medical help.