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:

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Benefits of LVAD?

Better Quality of Life
The LVAD helps patients with advanced heart failure take part in activities that were not possible before the implant. Our patients travel, exercise, return to work, and participate in activities they otherwise would not be able to.

Greater Life Expectancy
Patients with advanced heart failure who have an LVAD tend to live longer than those are treated with medical therapy alone.

Fewer Symptoms of Heart Failure
The LVAD can help reduce symptoms of heart failure such as extra fluid, shortness of breath and fatigue.

Fewer Hospitalizations
With reduced symptoms of heart failure, this helps patients feel better and avoid hospitalizations.

Possible risks of LVAD

• Stroke
• Bleeding
• Infection
• Right heart failure
• Device malfunction

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Surgery and Recovery

What to expect:
The cardiac surgeon will discuss the surgery including risks and benefits with you during your consultation. Our cardiac surgeon will be implanting the VAD through open heart surgery at Hartford Hospital. The duration of the surgery can last between four to six hours and require general anesthesia. You will be placed on a cardiopulmonary bypass machine which will provide oxygen and blood flow to your organs during the surgery.  After surgery, you will be taken to the Cardiothoracic ICU where you will be closely monitored while you recover from surgery.

Every patient’s recovery is different, so the amount of time you will be hospitalized varies based on individual needs. A typical hospital stay is about 2.5-3 weeks or longer to recover. Our goal is to help you recover as quickly and safely as possible. Depending on your mobility and physical endurance, you may require additional rehabilitation at a rehab facility. This will be determined by our team. If you are transitioned home, you will have visiting nurses and physical/occupational therapy services.

How long can you be supported by a LVAD?
The amount of time patients are supported by an LVAD varies. It can depend on the type of LVAD you have and whether it’s being used as permanent or temporary support.

How will I know how to care for my LVAD?
The LVAD coordinators will provide extensive and thorough education to patients and family members on managing the device and equipment, learning the alarms, and performing the sterile dressing change. You will learn how to trouble shoot alarms and potential emergency situations.

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Additional Information and patient education

Download the following brochures

HEARTMATE 3™ patient education

HEARTMATE 3™ patient guide

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