Heart Disease: Treating Heart Disease: Left Ventricular Assist Device

What Is an LVAD?

The left ventricular assist device, LVAD or VAD, is a kind of mechanical heart. It's placed inside a person's chest, where it helps the heart pump oxygen-rich blood throughout the body.

Unlike an artificial heart, the LVAD doesn't replace the heart. It just helps it do its job. This can mean the difference between life and death for a person whose heart needs a rest after open-heart surgery, or for a person waiting for a heart transplant.

Now, VADs play another role, allowing weakened hearts to recover. A permanent LVAD is currently being used in some terminally ill patients whose condition makes them ineligible for heart transplantation. This is also called destination therapy.

In studies, therapy with the permanent LVAD device doubled the one-year survival rate of patients with end-stage heart failure as compared with drug treatment alone. However, there were some risks including infection, stroke and bleeding.

How Does an LVAD Work?

Like the heart, the LVAD is a pump. One end hooks up to the left ventricle -- that's the chamber of the heart that pumps blood out of the lungs and into the body. The other end hooks up to the aorta, the body's main artery. A tube passes from the device through the skin. The outside of the tube is covered with a special material to aid in healing and allow the skin to regrow.

The pump and its connections are implanted during open-heart surgery. A computer controller, a power pack, and a reserve power pack remain outside the body. Some models let a person wear these external units on a belt or harness outside.

The power pack has to be recharged at night.

What Are the Benefits of an LVAD?

An LVAD restores normal blood flow to a person whose heart has been weakened by heart disease. This relieves symptoms such as being constantly tired or short of breath. And sometimes it lets the heart recover normal function by giving it a chance to rest.

What Are the Risks of an LVAD?

As with any surgical procedure, there is the risk that the operation will fail.

After surgery, there are other risks:

• Infection.
• Internal bleeding.
• Heart failure.
• Mechanical breakdown of the LVAD.

Talk to your doctor to find out if LVAD is right for you.

Reviewed by the doctors at The Cleveland Clinic Heart Center.