Overview
The Heart Failure Clinic at BLK-Max Super Speciality Hospital is one of the best for Left Ventricular Assist Devices (LVADs). These sophisticated devices are designed to support patients suffering from end-stage heart failure. LVAD treatment can be used for some patients who are waiting for a heart transplant and whose medical condition is unstable.
Our team of experts, consisting of heart failure cardiologists, VAD surgeons, interventional care surgeons, and VAD coordinators, holds years of experience in LVADs implantation as a bridge to transplant or as destination therapy. With our cutting-edge techniques and methods, we offer promising care for the diagnosis, assessment and treatment of patients suffering from heart failure.
Our department is equipped with state-of-the-art technologies that make the treatment even more accurate and safe. Our experts follow a multidisciplinary approach to create a patient-centric treatment plan for every patient that helps in improving the overall survival outcomes and quality of life.
What is Left Ventricular Assist Device (LVAD)
LVAD, or Left Ventricular Assist Device, is an implantable mechanical pump used to help patients suffering from end-stage heart failure to assist the left ventricle in pumping blood to various parts of the patient's body. It is a small, mechanical circulatory support device that runs on a battery and is surgically placed inside the patient's heart. It can be used as the destination therapy for patients who are not eligible for transplants.
Unlike a total artificial heart, LVAD treatment doesn't replace the heart; rather, it just assists the heart in performing its functions more accurately and without much strain. The device can help to postpone the need for a heart transplant. It thereby helps to keep the patient alive until a suitable donor is found. It also helps in improving the quality of life in patients with chronic heart failure whose symptoms are not controlled by maximum medical treatment and who are not heart transplant candidates.
Alternate Name of LVAD
LVAD is also known as a mechanical circulatory support device
Indicators of Left Ventricular Assist Device (LVAD) Treatment
Left ventricular assist device can be used to help patients suffering from a wide range of chronic heart ailments. These include
- Severe symptomatic heart failure
- Postpericardiotomy shock
- Severe left ventricular dysfunction
- Advanced heart failure with optimum medical management
- Patient waiting for transplantation
- Heart Failure accompanied by other organ dysfunctions
Heart Conditions Treat with LVAD
LVADs treat people with advanced heart failure conditions which include patients who:
- Are too poor or too old to undergo heart transplantation
- Are on the transplant list but are not stable enough to wait for a donor's heart
- Had a massive heart attack and left with no other treatment options
- Have a very high body mass index (BMI) for a heart transplant
- Have advanced stages of Myocarditis or Dilated Cardiomyopathy
- Have a health issue that precludes heart transplant
- Have experienced organ rejection especially after heart transplantation
- Have undergone heart surgery but are not in a condition to be removed from cardiopulmonary bypass
The LVAD is used under three categories such as:
- Short-Term: For patients with high complications and cannot sustain life over the long term
- Intermediate-Term: For patients with high complications for up to 500 days
- Long-Term: For patients with advanced heart failure conditions and need support outside the hospital.
Who is Eligible for LVAD
For certain patients with end-stage heart failure, an LVAD is the most appropriate treatment option. However, the doctor will thoroughly evaluate the patient before advising to undergo the surgery. An LVAD is an option for:
- Patients waiting for a heart transplant
- Patients who have to undergo heart surgery and the recovery time is more.
- Patients who can’t have a heart transplant
An LVAD treatment is not an option for patients with medical conditions such as
- Clotting problems
- Kidney failure
- Liver disease
- Lung disease
- Infections
Diagnosis Tests Required For Left Ventricular Assist Device (LVAD)
The doctors may conduct several tests like:
- Electrocardiogram
- Metabolic stress test
- Echocardiogram
- Cardiac MRI
- Cardiac Catheterisation
- CT Scan
- Chest X-ray
- Blood test
All these tests are performed prior to the transplant in our specialized labs.
LVAD (Left Ventricular Assist Device) Procedure
LVAD Preoperative
A doctor will evaluate the patient and counsel him/her for the possible complications that may arise during the LVAD procedure. He might even prescribe some investigations. The doctor might prescribe relevant medications to reduce the risks prior to the procedure. The patient must not eat anything for at least 12 hours starting a night before the surgery.
LVAD Operative
- STEP 1: The area of the body where the LVAD procedure has to be performed is numbed using general anaesthesia.
- STEP 2: In order to access the heart, the surgeon will make a long incision on the breastbone and spread the rib cage. In most of the complex cases, doctors place the patient on a cardiopulmonary bypass machine, which takes over the functioning of the heart and lungs until the operation is complete.
- STEP 3: The surgeon now connects the LVAD inside the patient’s heart.
- One end of the LVAD tube is connected to the heart’s left ventricle and its other end exits from the aorta.
- Now a small electrical cord is connected to the LVAD (a driveline) which exits from the upper abdomen and is connected to a power supply (which can be a battery or a plug-in) which is operated using a small computer.
- STEP 4: The device is tested for its proper functioning.
- STEP 5: The patient is taken off the cardiopulmonary bypass and the chest is closed with stitches.
LVAD Post-Operative
The patient has to spend a day or two in the intensive care unit for monitoring purpose. He/she has to be on a respirator for a day for breathing assistance. After surgery, most people become asymptomatic and start to feel better. However, certain medication and precautionary measures may be recommended to avoid the recurrence of such problems in future.
Benefits of Left Ventricular Assist Device (LVAD)
LVAD can prove to be highly beneficial in certain cases and has a wide range of benefits
- It can help by increasing the blood flows to different organs of the body thereby, enhancing their functioning.
- It can reduce the symptoms thereby helping you lead a better quality of life
- It can be used to treat patients who are not considered to be eligible for a heart transplant.
- It can even help patients with advanced heart failure.
- In some cases, the patient's heart may resume its normal functioning.
Precautions Take After LAVD Procedure
Some of the major precautionary measures a patient must take after the LVAD procedure are:
- Be punctual with the medicines
- Maintain a healthy lifestyle
- Blood pressure management is a must
- Always keep an extra set of the controller and fully charged spare batteries
- At least one of the power sources must be connected to the device all the time
- Do not disconnect the driveline from the pump or the controller
- Never disconnect from two power sources(batteries or power adapters) at the same time
- Don’t take stress or live/work in a stressful environment
- Maintain a healthy BMI
LAVD Procedure Complications
BLK-Max Super Speciality Hospital has a high success rate in performing Left Ventricular Assist Device (LVAD) but sometimes risks cannot be averted and depend on the condition of a patient. Possible complications that may arise after the procedure include:
Very Common Complications
- Damage to your blood vessels
- Blood Clot
- Device malfunctions
- Internal bleeding
Rare Complications
- Heart attack
- Right heart failure
- Respiratory failure
- Kidney failure
- Death (in rare cases)
A patient must seek immediate medical assistance if the complications do not improve.
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