Heart failure can make your heart too weak to pump out enough oxygen-rich blood to meet your body's needs. That will leave you tired and short of breath. It may be hard to climb stairs, go to work, or exercise.
One way to get your heart back into a healthy rhythm, and help you get back to your normal routine, is with an implanted left ventricular assist device (LVAD). An LVAD takes over some of the work for your heart.
What Is an LVAD?
The left ventricle is one of the heart's four chambers. Located in the bottom left part of the heart, it pumps oxygen-rich blood out to the body.
An LVAD is a battery-powered pump that helps your weakened left ventricle push blood out to your body.
The LVAD pump pulls blood from your left ventricle through one tube. Then it pushes blood through another tube into your aorta, which is the large artery that sends blood out to your body.
You’ll get surgery to implant the pump in the upper part of your abdomen. It's attached via a tube to a battery and control system that you wear outside of your body. Thanks to new technology, the outside parts of the LVAD have gotten smaller in recent years.
Who Needs One?
Your doctor may recommend an LVAD if your left ventricle is damaged enough to affect its ability to pump effectively.
An LVAD can be a short-term fix to keep your heart pumping while you wait for a heart transplant. In this case, doctors call it a "bridge to transplant." You might also use an LVAD temporarily while your heart heals after heart surgery.
The pump can also be a long-term option. It can continue to pump for your left ventricle if a transplant isn't an option for you. If you use an LVAD permanently, your doctor may call it "destination therapy."
The Pros and Cons
An LVAD will help you get back to your normal life while you wait for a transplant or recover from heart surgery. You’ll have more energy to exercise, go to work, and do the other things that you used to do without getting too tired or short of breath.
LVADs do have some risks, though. These include:
- Blood clots that could lead to a stroke
- Problems with the device, including pumping issues or a power failure
- Right heart failure. Because the LVAD only supports the left ventricle, it forces the weakened right ventricle to pump more blood than it may be able to handle.
Your doctor will go over these risks with you and tell you what you can do to avoid them.
Are You a Good Candidate?
To get an LVAD, your left ventricle has to be damaged enough to need the pump. Yet your body has to be healthy enough to undergo surgery.
An LVAD may be an option if you have heart failure and you:
- Are waiting for a heart transplant
- Will have heart surgery and your heart needs time to recover
- Can't have a heart transplant
LVADs aren't recommended for people who have:
What to Expect
After the surgery, the doctors, nurses, and other staff will show you how to care for your LVAD. Once you're home, you'll likely need to take medicines such as warfarin (Coumadin) or aspirin to help prevent clots from forming in your heart or LVAD. You'll need to take these medicines for as long as you have the device.
You'll also have to stay on your heart failure medicines, which could include a diuretic (a “water pill”) or blood pressure drugs. Your doctor may change the doses because of your LVAD.
Because you'll have an opening in your skin, you'll need to keep the area clean to prevent infection. Call your doctor if you notice these signs of infection:
- Fluid draining from the area where the tubes leave your skin
- Redness and swelling over the area
It may take some time for you to get used to your new device. The doctor might recommend that you do cardiac rehabilitation to help you adjust. This program will teach you how to eat the right foods, exercise, and reduce stress to stay healthy with your new device. You may need to visit an outpatient center every week for the first month, and then every other week to check your progress.
You will likely be able to work, exercise, and do most of your other normal activities. But you may need to make a few adjustments. You won't be able to swim or play contact sports. When you travel by plane, you'll need to tell security that you're wearing a device. And you'll have to make sure your LVAD batteries are always charged. You can charge it while you sleep by plugging it into an outlet. Some LVADs also plug into car chargers.