What is a left ventricular assist device?
A left ventricular assist device (LVAD) is a mechanical “heart pump” that is surgically implanted through open heart surgery in patients with heart failure. The pump is inserted into the left ventricle to help distribute blood throughout your body. The device does not replace the heart, it pumps along with the patient’s own heart. It helps the pumping chamber of the heart (left ventricle) pump blood out of the ventricle to the aorta and the rest of your body. The pump is implanted during a procedure in the hospital. The LVAD helps patients with heart failure live longer and return to things they were doing before they were limited by heart failure.
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Who might need an LVAD?
Patients awaiting a heart transplant (Bridge to Transplant)
Some patients with heart failure may be candidates for a heart transplant. An LVAD may be implanted temporarily to help support the failing heart while they wait for a transplant. Once the donor heart is available, the LVAD will be removed.
Patients eligible for a heart transplant due to age or other factors (Destination Therapy)
Some patients with heart failure may not be candidates for heart transplant. An LVAD would be permanently implanted for the remainder of their lives. This long-term option can add years to the patient’s life.
Patients with temporary heart failure (Bridge to Recovery)
Some patients with heart failure might need temporary support from an LVAD while their heart is healing from an injury or illness.
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Types of LVADs
Long Term or Durable VADs
The current LVAD device that we implant at Hartford Hospital is known as the HeartMate 3. This is approved by the US Food and Drug Administration (FDA). We do continue to support patients on other devices such as the HeartWare and HeartMate II.
Short Term or Temporary VADs
For patients with respiratory and/or cardiac failure, time is indeed a matter of life and death. That’s why an innovative procedure known as Extracorporeal Membrane Oxygenation (ECMO), is helping to give the human body the time it needs to heal.
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How does the LVAD work?
The LVAD has four main parts:
The pump: The pump is inserted into the left ventricle through open heart surgery. A tube then delivers this blood from the pump to the aorta. The pump works by continuously pumping blood into the aorta.
The driveline: A thin cord that will exit the body from the abdomen to connect the internal pump to the controller outside of the body. A sterile dressing will cover this site.
The controller: A small control system outside of the body that runs the pumps and communicates alarms and battery life.
The Power Sources: Rechargeable batteries or a mobile power unit (MPU) that plugs into an electrical outlet provides power to the pump and allows the device to operate. A power source must be connected at all times for the pump to run.
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Evaluation and Diagnostic Testing
If you are a candidate for a VAD, an evaluation will be completed by our multidisciplinary team. The team works together to determine if a VAD is the best treatment option for you and will ultimately improve your quality of life. The team will thoroughly review your medical records as well as schedule in-person or telephone appointments for additional consults. In addition, you will also undergo diagnostic testing and imaging and meet with the VAD coordinators for an educational overview to introduce the device. The evaluation can be completed inpatient if you are hospitalized or on an outpatient basis.
To decide if a VAD is the right treatment option for you, the team will consider:
- The severity of your heart failure
- How well your heart is working
- Your ability to take blood thinners
- Your social support system
- Your mental health and ability to care for a VAD
- Any other medical conditions you have
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Our Team
If you’re a candidate for an LAVD, here’s a closer look at our team of specialists who will work with you to help develop your plan of care:
Cardiac Surgeons Our surgeon will meet with you as part of your evaluation to discuss the risks and benefits of surgery. They will discuss how this decision will affect you and your lifestyle. |
Advanced Heart Failure Cardiologist Our cardiologists will provide medical management and guidance of your cardiac disease. They will present your case to the team during a multidisciplinary meeting to determine if you are a candidate for a VAD. The cardiologist will continue to manage and provide follow up care. |
VAD Advanced Nurse Practitioner Our VAD nurse practitioner is in continuous communication with the VAD coordinators. They will be involved in the outpatient setting after implantation when you are seen in the clinic. The nurse practitioner will see you during some of your clinic visits as well as prescribe and adjust your heart failure medications, interpret labs, make referrals to other specialties and prescribe additional services as needed. |
VAD Nurse Coordinators Our VAD coordinators will meet with you during the evaluation process to introduce the device and go through an overview with you and your support persons. They will provide education before and after the surgery. The VAD coordinators will be with you throughout the entire evaluation process and post-op course if you are a candidate for a VAD. They will help assist with communication between the physicians, you and your family. |
Social Worker Our social worker will evaluate your support system and determine your ability to cope with the stress of a VAD as well as the ability to follow the treatment plan. Our program requires primary and backup support persons. |
Registered Dietitians Our dietitians will perform a nutritional assessment and make recommendations for healthy eating to maintain a healthy weight and lifestyle. They also will discuss diet interactions with the blood thinner you will be on. |
Palliative Care Our palliative care providers will provide support to you and your family throughout this process. They will discuss your goals of care and goals to improve your quality of life. |
Physical Therapy and Occupational Therapy Our therapists will assess your mobility, dexterity, and balance. They will evaluate if you would be able to manage the device and make connections. |
Financial Coordinator Our financial coordinator will review your insurance coverage and benefits related to the VAD surgery. |