LVAD Evaluation. LVADs can be used as: Bridge-to-transplant therapy : This is a life-saving therapy for patients awaiting a heart transplant. Patients use the LVAD until a heart becomes available. In some cases, the LVAD is able to restore the failing heart, eliminating the need for a transplant. Learn more about heart transplant. Destination therapy : Some patients are not candidates for heart transplants.
In this case, patients can receive long-term treatment using an LVAD, which can prolong and improve patients' lives. Experience : Our Stanford's Heart Failure and Cardiomyopathy Clinic has more than 30 years of research and clinical experience. Learn more about our Heart Failure and Cardiomyopathy Clinic. Latest treatments : Our involvement in heart failure research means we are at the forefront of the latest advancements in the diagnosis and treatment of heart failure. We have the newest devices available today and our experts work with every type of device.
Minimally invasive approaches : Our cardiac surgeons have invented new ways to implant LVADs that avoid splitting the breast bone. High volume : We are one of only two destination therapy programs in the Bay Area and one of seven in all of California. We treat the highest volume of patients in the Bay Area, giving us a superior level of experience and expertise.
How will my medications changed after an LVAD procedure? What is life like after a VAD implantation? It may also help improve the function of other organs in your body that may not be working properly and may improve other medical conditions. When a VAD is implanted while you're waiting for a heart transplant, it's referred to as a "bridge to transplant. You're not currently eligible for a heart transplant because of age or other conditions. A VAD may sometimes be implanted if you have heart failure, but you're not eligible for a heart transplant due to age or other medical conditions.
This is called "destination therapy. In selected cases, the VAD may help improve the function of other organs that aren't working properly or improve other medical conditions that may be keeping you from being a candidate for a heart transplant. In some cases, the VAD may improve these conditions so that you can become a heart transplant candidate, or you may keep the VAD as a permanent treatment.
VADs are increasingly being used as a long-term treatment for people who have heart failure but aren't good candidates for a heart transplant. Generally if you're older than age 65, you may not be eligible for heart transplantation. In that situation the VAD would be implanted as therapy for heart failure. A VAD can enhance your quality of life. Your heart's function can become normal again. If your heart failure is temporary, your doctor may recommend implanting a VAD until your heart is healthy enough to pump blood on its own again.
This is referred to as "bridge to recovery. It's also possible you'll have a VAD implanted for a short time during or after having heart surgery. You may have a VAD implanted for a few weeks or months.
RVADs may be temporarily implanted after some heart surgeries. A RVAD can help keep blood flowing from the right ventricle to your lungs. If a VAD can't help your heart, your doctor may consider a total artificial heart as a treatment option. This device replaces the two lower heart chambers ventricles of your heart. This option is generally only considered in people with severe heart failure whose conditions haven't improved through other treatments.
It may be an option while you're waiting for a heart transplant. Your doctor will discuss with you whether a total artificial heart is an appropriate treatment option for you. Blood clots. As your blood moves through your VAD , blood clots may form. Blood clots can slow or block normal blood flow through your heart, which can lead to stroke or heart attack, or cause your VAD to stop working. Your doctor will prescribe blood-thinning medications, including warfarin Coumadin, Jantoven and aspirin to help prevent blood clots after your VAD is implanted.
You'll need to have regular blood tests to monitor warfarin's effects. It's very important to follow the instructions for taking warfarin carefully. Warfarin is a medication that can have dangerous side effects if not taken exactly as instructed, so talk to your doctor about any special instructions you'll need to follow. Because the power source and control unit for your VAD are located outside your body and are connected through a port in your skin, there's an increased risk of germs getting in the port and causing a serious infection.
You, your family and your treatment team will need to watch carefully for signs of infection, such as soreness or redness near the port, fluid draining from the site, or a fever. Right heart failure. If you have an LVAD implanted, it will pump more blood from the left ventricle of your heart than what your heart might have been used to. Your right ventricle may be too weak to pump the increased amount of blood.
If you develop right heart failure, medications or other therapies may help improve the pumping ability of the right ventricle. An RVAD might be implanted to support the right ventricle if you develop this complication. Before surgery to have a ventricular assist device VAD implanted, your doctor and treatment team will explain to you what to expect before, during and after the surgery and potential risks of the surgery.
Your doctor and team will discuss concerns you may have about your VAD surgery. Your doctor or another member of your treatment team may discuss with you advance directives or other information to consider prior to your surgery. You'll need to have your hair shaved off at the location of your body where the procedure will take place.
Before being admitted to the hospital for your surgery, talk to your family about your hospital stay and discuss help you may need when you return home. Your doctor and treatment team may give you specific instructions to follow during your recovery when you return home. Before your ventricular assist device VAD is implanted, you'll likely need to stay in the hospital for several days preparing for your surgery.
Having an LVAD inserted is major surgery, however, and there are some risks. Read on to learn about these devices, the insertion procedure, recovery times, and more. An LVAD is a device that helps the left side of the heart to pump blood. In a person with heart failure, a surgeon attaches an LVAD to the heart to help promote blood flow. A person awaiting a heart transplant may greatly benefit from having an LVAD in the meantime.
This tube carries blood from the heart to the blood vessels. The device also contains a power source and a control unit that allows the person to check how well their LVAD is working. Learn how the heart pumps blood here. Because inserting the device requires major surgery, a doctor only recommends an LVAD to people with heart failure in the following circumstances :. Implanting an LVAD is open-heart surgery. The person receives a general anesthetic and medication to prevent blood clots.
During the procedure, the surgeon inserts the pump in the upper part of the stomach wall. The pump has a tube that connects to the heart. The medical team typically uses medications to stop the heart during the surgery. In this case, they employ a heart-lung bypass machine to keep oxygenated blood flowing throughout the body.
The entire LVAD implantation procedure takes 4—8 hours , after which doctors awaken the patient and recovery begins. Learn more about open heart surgery here. People initially recover in an intensive care unit for around 3—5 days. They, they are moved to a more general ward of the hospital for around 2—3 weeks. Discharge timing will depend on your physical recovery, medical condition, and familiarity with caring for the LVAD.
Some patients stay in an intermediate care facility or rehabilitation center until they are fully ready to return home. Your physician may prescribe a combination of different medications to support your overall health and heart function, and to prevent complications related to the LVAD.
Every patient has different medication needs, based on current health status and medical history. In general, all LVAD patients take blood thinners warfarin and aspirin to help prevent blood clots from forming inside the pump.
You also can expect to be on many of the same medications you were taking for heart failure, including beta blockers, ACE inhibitors or angiotensin II receptor blockers ARBs , and diuretics water pills. Recovering and returning to routine daily activities after receiving an LVAD is a gradual process. After receiving an LVAD, you will be able to perform most activities.
You can shower, bicycle, hike, and even return to work, in some cases. You also can travel, with minor accommodations. You must keep your equipment with you at all times not checked in cargo , and your route and destination should include areas with an LVAD program, just in case of an emergency. LVAD patients cannot swim or take a bath, play contact sports, lift heavy weights, or be away from an electrical power source.
If you are feeling especially worried or stressed, reach out to your treatment team, family, and friends. You also may want to consider joining an LVAD support group or talking with a professional counselor. Reviewed by: Amy E.
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