What Is a Left Ventricular Assist Device (LVAD)?
A ventricular assist device (VAD) is a mechanical pump that assists the heart to pump blood from the ventricles, the lower chambers of the heart, out to the body in people who have end-stage heart failure (HF).1-2 It is a mechanical circulatory support device that is implanted inside the chest during open-heart surgery.2-3 The procedure generally takes four to six hours.
A VAD can be placed in either the left, right or both ventricles of the heart, but is most often placed in the left ventricle, thus called a left ventricular assist device (LVAD).1,2 It is made up of multiple parts. A tube (graft) directs blood from the left ventricle to a pump. The pump then delivers blood through a second tube (graft) to the aorta which delivers blood to the body. There is a cable (driveline) that runs from the pump outside your body through the skin and connects to a control unit and battery pack power source located outside the body.2,3
Through advances in technology, VADs are smaller, portable, have fewer complications, and have longer-lasting batteries. This allows patients who receive VADs to go home and live normal lives.
Waiting for transplant
The only cure for end-stage heart failure is a heart transplant, but not all people with end-stage heart failure are eligible to get a transplant. Because donors' hearts are limited, most people who are determined eligible for a transplant will have to wait for a heart to become available.1 Both the heart and the general medical condition of a patient may continue to decline while awaiting a transplant. An LVAD can be a temporary solution while waiting for a donor heart to become available. This is called a "bridge to transplant.2,3
An LVAD keeps pumping the blood for the damaged heart until a new one can be found. With improved blood flow, more oxygen can reach the vital organs including the kidneys, liver, and lungs. This can improve a patient's overall condition allowing them to wait for a heart transplant.2
Not all patients are eligible for heart transplants due to age or other comorbid conditions. The FDA approved the LVAD device for patients as destination therapy in 2010.3 This allows its usage for people with heart failure who are not candidates for heart transplant surgery.2
An LVAD that is used as a long-term treatment for heart failure is called destination therapy.1 It can enhance a patient's quality of life and extend the duration of their life. As in the case of a transplant, to be eligible for an LVAD, a patient has to complete a thorough evaluation to make sure they are a good candidate for the device and the associated open heart surgery.2
Additionally, VADs are sometimes implanted on a temporary basis; before or after cardiac surgery or while waiting for the heart to become strong enough to beat properly on its own again.2
The insertion of a VAD is considered major surgery. As part of the recovery, cardiac rehabilitation will likely be recommended by your healthcare team. Cardiac rehab is a program of monitored exercise and education on a heart-healthy lifestyle, designed to facilitate recovery and to teach people to live a healthy and active life. Cardiac rehab is an individualized program designed to meet the needs and lifestyle of each person and their general health condition.2