An LVAD (Left Ventricular Assistance Device) is a mechanical pump implanted on a weakened ventricle that helps the heart function normally by assisting the heart to pump blood throughout the body. It is considered an artificial heart, but people with these devices still have their hearts.
It is often used by patients waiting for a transplant (bridge to transplant), but it can also be used on people, not eligible for a transplant, to extend their lives and allow them to function normally.
LVAD
A Left Ventricular Assist Device (LVAD) does not beat like a natural heart; instead, it continuously pumps blood to assist the heart's function. The pumping rate of an LVAD typically ranges from 70 to 100 beats per minute, depending on the specific device settings and the patient's condition. Therefore, for a 65-year-old female patient, the LVAD would be expected to pump blood at this rate rather than beat like a heart.
He's wearing two large batteries that power his implanted left ventricle assist device (LVAD) and a sophisticated "controller" (a programmed computer) that governs and monitors its operation. The LVAD is not a pump, but more like a turbine than spins around 9000 rpm and moves the blood that would otherwise flow into the left ventricle directly into the aorta. Power and programming flow through a drive line to the LVAD that exits through the abdomen.
An LVAD (Left Ventricular Assistance Device) is a mechanical pump implanted on a weakened ventricle that helps the heart function normally by assisting the heart to pump blood throughout the body. It is considered an artificial heart, but people with these devices still have their hearts. It is often used by patients waiting for a transplant (bridge to transplant), but it can also be used on people, not eligible for a transplant, to extend their lives and allow them to function normally.
A VAD is a temporary life-sustaining device. VADs can replace the left ventricle (LVAD), the right ventricle (RVAD), or both ventricles
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A person with a left ventricular assist device (LVAD) can live for several years, with many patients experiencing an increased quality of life. On average, LVAD recipients can live between 2 to 5 years, and some have lived beyond 10 years, depending on their overall health, the underlying heart condition, and adherence to medical care. Advances in technology and management may continue to improve the longevity of patients with LVADs. Regular follow-up and monitoring are crucial for maximizing the benefits of the device.
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Axial flow LVADs have a propeller-like rotor that spins along the device's long axis to propel blood forward, while centrifugal flow LVADs use a rotating impeller to draw blood into the device and then expel it outward. Centrifugal flow LVADs are generally more compact and have fewer moving parts compared to axial flow LVADs.
Heart surgery refers to various surgical procedures performed on the heart or blood vessels connected to the heart. These procedures are typically performed to treat heart conditions and improve heart function. Here are some common heart surgery treatments and procedures: Coronary Artery Bypass Grafting (CABG): This procedure is used to treat blocked or narrowed coronary arteries. During CABG, blood vessels, often taken from the patient's leg or chest, are used to create bypasses around the blocked arteries, improving blood flow to the heart. Heart Valve Repair or Replacement: Heart valves that are diseased or damaged may require repair or replacement. This can involve procedures like valve repair (reshaping the valve) or valve replacement (using mechanical or biological prosthetic valves). Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) Repair: ASD and VSD are congenital heart defects characterized by abnormal openings between the heart chambers. Surgical repair involves closing these openings with sutures or a patch. Transmyocardial Laser Revascularization (TMR): TMR is a procedure used to relieve severe angina (chest pain) in patients who are not candidates for other procedures like angioplasty or bypass surgery. It involves using laser energy to create channels in the heart muscle, which stimulate the growth of new blood vessels. Heart Transplant: In cases of end-stage heart failure, a heart transplant may be considered. This involves replacing a diseased or failing heart with a healthy heart from a deceased donor. Left Ventricular Assist Device (LVAD) Implantation: An LVAD is a mechanical pump implanted in the chest to assist the weakened left ventricle in pumping blood. It is used as a bridge to heart transplant or as destination therapy for patients who are not transplant candidates. Transcatheter Aortic Valve Replacement (TAVR): TAVR is a minimally invasive procedure used to replace a diseased aortic valve without open-heart surgery. A catheter is used to deliver a new valve into the heart, typically through an artery in the leg. It's important to note that the specific treatment or procedure recommended for a patient depends on their individual condition, overall health, and the recommendations of their healthcare team. The information provided here is a general overview and not exhaustive.
DefinitionVentricular assist devices (VAD) help your heart pump blood from the main pumping chamber of your heart (the left ventricle) to the rest of your body. These pumps may be implanted in your body or connected to a pump outside your body.Alternative NamesVAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist deviceDescriptionA ventricular assist device has three parts:A pump. The pump weighs 1 to 2 pounds. It is placed in your belly if you will need it permanently, or it may also be used outside of your body when you are waiting for a permanent pump or a heart transplant.An electronic controller. The controller is like a small computer that controls how the pump works.Two batteries. The batteries are carried outside your body. They are connected to the pump with a cable that goes into your bellyYou will need general anesthesia when your VAD is implanted. This will make you unconscious and unable to feel pain during the procedure.During surgery to implant the pump, the heart surgeon opens the middle of your chest with a surgical cut and then separates your breastbone. This allows the surgeon to reach your heart. Next, the surgeon will make space for the pump under your skin and tissue in the upper part of your belly wall. Then, the surgeon will place the pump in this space.A tube will connect the pump to your heart. Another tube will connect the pump to your aorta or one of your other major arteries. Another tube will be passed through your skin to connect the pump to the controller and batteries.The VAD will take blood from your left ventricle through the tube that leads to the pump. Then the device will pump the blood back out to one of your arteries and through your body.Surgery usually lasts 4 to 6 hours.Why the Procedure Is PerformedYou may need a VAD if you have severe heart failure that cannot be controlled with medicine or a special pacemaker. You may be on a waiting list for a heart transplant. Some patients who get a VAD are very ill and may already be on a heart-lung bypass machine.Not every patient with severe heart failure is a good candidate for this procedure.RisksRisks for this surgery are:Blood clots in the legs that may travel to the lungsBreathing problemsHeart attack or strokeAllergic reactions to the anesthesia medicines used during surgeryInfectionsBefore the ProcedureMost people will already be in the hospital for treatment of their heart failure.After the ProcedureMost people who are put on a VAD spend up to 5 days in the intensive care unit after surgery. You may stay in the hospital anywhere from 2 to 8 weeks after you have had the pump placed. During this time you will learn how to care for the pump.OutlookA VAD may help people who have heart failure live longer. It can also help improve quality of life.ReferencesNaka Y and Rose EA. Assisted circulation in the treatment of heart failure. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo; WB Saunders; 2007:chap. 28.Slaughter MS, Rogers JG, Milano CA, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009 Dec 3;361(23):2241-51.
DescriptionAlthough most of treating heart failure is changing your lifestyle and taking your medicines correctly, procedures and surgeries still play a role.Pacemakers and DefibrillatorsA heart pacemaker is a small, battery-operated device that sends a signal to your heart. The signal makes your heart beat at the correct pace. Pacemakers may be used:For people who have heart problems that cause their heart to beat too slowly, too fast, or in an irregular mannerFor people with heart failure, to match up the beating of both sides of the heart. These are called biventricular pacemakers.When your heart is weakened, gets too large, and does not pump blood very well, you are at high risk for life-threatening heartbeats.An implantable cardioverter-defibrillator (ICD) is a device that detects any life-threatening heartbeats. It then quickly sends an electrical shock to the heart to change the rhythm back to normal.Most of today's biventricular pacemakers can also work as implantable cardio-defibrillators (ICD).Surgery to Improve Blood Supply to the HeartThe most common cause of heart failure when the heart does not beat strongly enough is coronary artery disease (CAD), a narrowing of the small blood vessels that supply blood and oxygen to the heart. CAD may become worse and make it harder to manage your symptoms.After performing certain tests, your doctor may feel that opening a narrowed or blocked blood vessel will improve your heart failure symptoms. Suggested procedures may include:Angioplasty and stent placementHeart bypass surgeryHeart Valve SurgeryBlood that flows between different chambers of your heart or out of your heart into the aorta must pass through a heart valve. These valves open up enough so that blood can flow through. They then close, keeping blood from flowing backward.When these valves do not work well, blood does not flow correctly through the heart to the body. This problem may cause heart failure or make heart failure worse.As a result, the patient may need surgery to repair one of the heart valves.Surgery for End-stage Heart FailureSevere heart failure may need the following treatments when other therapies no longer work. They are often used when a person is waiting for a heart transplant.You may need a left ventricular assist device (LVAD) if you have severe heart failure that cannot be controlled with medicine or a special pacemaker.Ventricular assist devices (VAD) help your heart pump blood from the main pumping chamber of your heart to the rest of your body. These pumps may be implanted in your body or connected to a pump outside your body.You may be on a waiting list for a heart transplant. Some patients who get a VAD are very ill and may already be on a heart-lung bypass machine.Intra-aortic balloon pumps (IABP) help maintain heart function in patients who are waiting for transplants. They can also help those who develop a sudden and severe decline in heart function. The IABP is an implanted thin balloon that is usually inserted temporarily into the artery in the leg and threaded up to the aorta leading from the heart.ReferencesMann DL. Management of heart failure patients with reduced ejection fraction. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 28.Otto CM, Bonow RO. Valvular heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 66.Reviewed ByReview Date: 07/29/2011Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.