LVADs for End-Stage Heart Failure: An Alternative to Transplants
Continuous-Flow LVADs continued...
What's more, patients implanted with the new continuous-flow pump were twice
as likely to live for at least two years following surgery, according to the
report in the Dec. 3, 2009, issue of the New England Journal of
Medicine. And they were four times as likely to survive for two years as
patients on drug therapy alone.
In addition, the continuous-flow LVAD was associated with fewer infections
and a significantly lower rate of failure.
"The continuous-flow LVAD has changed the landscape of advanced heart
failure," says James C. Fang, MD, chief medical officer of the
Harrington-McLaughlin Heart and Vascular Institute at University Hospitals Case
Medical Center in Cleveland and the author of an editorial on LVADs that
accompanied the study in the New England Journal of Medicine.
"In addition to being more durable, the new device is a lot smaller -- about
the size of a D battery. It's also quiet. You can barely hear it. With the old
devices, you could hear them coming down the street."
LVADs: Risks and Warnings
Though LVADs offer new hope to many people with heart failure, it's
important to understand the drawbacks. They don't work for everyone. They also
pose an increased risk of stroke. Some people with LVADs need to take
anticoagulants to lower the odds of stroke.
And despite their successes, LVADs are still a new treatment. Yancy
estimates that a few thousand people have received them so far. Hundreds more
will get them this year. That's a small number compared to the tens of
thousands who could potentially benefit. About 100 centers in the country have
the expertise to implant them.
To get an LVAD, a person would also have to meet some eligibility
requirements. The good news is that some older people who might not qualify for
a transplant might be able to get an LVAD instead. The bad news is that others
who are too sick for a transplant might also be too sick for an LVAD.
Being a good candidate for an LVAD also depends on your current treatment
"Before people are eligible to get an LVAD, it is imperative that they are
already getting the best possible treatment," Yancy tells WebMD. They need to
be taking their medication as prescribed, getting regular checkups with
doctors, and following any lifestyle advice -- like sticking to a low-sodium
diet. People who aren't doing these things -- or who have other issues, like
heavy alcohol use -- might not qualify for an LVAD.
If you're wondering if an LVAD might help you, talk to your doctor. See if
any local medical centers are qualified to implant LVADs. And in the meantime,
make sure to follow your doctor's heart failure treatment plan closely.