LVAD Device Explained: Benefits, Risks, and Recovery

You might find yourself in a situation where your doctor recommends getting an LVAD (Left Ventricular Assist Device) after being diagnosed with Heart Failure. But what is an LVAD? And why do you need it? LVAD is a battery-operated heart pump that is implanted through surgery in your heart that is no longer supplying enough blood. 

Although an LVAD surgery comes with many risks, like any other surgery, the benefits the LVAD device holds have changed lives. But you still need some time to recover completely. How fast someone recovers depends a lot on their health before surgery and the technique used during the procedure. 

Let’s talk in detail about the LVAD device and how it is giving life to its users.

What is an LVAD device? Or what is a LVAD heart pump?

A left ventricular assist device is implanted in your heart when it is not doing its job properly, because of your heart condition. Normally, your heart pumps blood from the left ventricle into the main artery, from where it goes to the whole body and supplies oxygenated blood to each organ and tissue. Now, imagine what will happen if your heart becomes too weak to pump blood. 

Your body needs blood to perform normal functions, but when the blood supply is cut off, it will obviously cause complications. That is when your doctor may decide that you need an LVAD to restore blood circulation. Because it is implanted in your left ventricle, this is why it is called a Left Ventricular Assist Device or LVAD heart pump. And in severe cases, both right and left ventricles receive a pump, which is known as a biventricular assistive device.

What’s surprising here is that an LVAD is not a cure for your heart condition, but still, it has been used widely. The LVAD device is only implanted to compensate for a weak heart. You receive an LVAD implantation surgery if you are still on the waiting list for a heart transplant. However, it’s not unusual to use it as a permanent treatment because not all patients are suitable for a heart transplant. 

LVAD vs Pacemaker: How are they different?

You may confuse LVAD with a pacemaker, but they are two different devices with two different purposes. Although they both are implanted in your heart and assist the heart in performing normal functioning, they both differ in their purpose.  Here are the key differences in the devices: 

What are the types of LVAD devices?

LVAD devices have come a long way over the years and are generally available in first, second, and third generations, each with its own set of advantages. Let’s take a look at these types:

Heartmate 3 LVAD

Heartmate 3 is the most advanced type of LVAD device. It allows the centrifugal flow of the blood that operates magnetically. This type of device allows less damage to red blood cells, so it reduces the risk of blood clot formation and complications associated with it. 

Heartmate 2 LVAD

Heartmate 2 LVAD is a device that uses axial flow of pump to allow blood circulation. This type of device has the advantage of being smaller in size, which allows the surgeon to use this device in a range of patients, including pediatric and older populations. 

HeartWare LVAD

HeartWare LVAD is also a pump that allows centrifugal flow, but this device has been discontinued due to the high risk of neurological complications like stroke. However, LVAD battery vests are still in use for such devices to allow the patients to live with a high-quality life index.

Jarvik 2000

This type of LVAD is still in its experimental phases. The Jarvik 2000 is an axial flow pump just like HeartMate 2, but it differs from the other devices in a way that it has a driveline behind the ear, whereas the other LVAD devices have drivelines in the abdominal area from where they exit the body.

BrioVAD

BrioVAD is another device in development and not widely used just yet. It is currently in experimental phase so that we can observe its potential to offer better performance and reliability, especially for patients who may not be ideal candidates for other types of LVADs.

Accessories you may need after having an LVAD Device

Receiving an LVAD surely makes your symptoms of heart failure go away. But, do you know what comes after it? You may need to have LVAD accessories to allow maximum mobility. LVAD apparel is specifically designed for you to carry components of the device, which may include batteries and the controller. These accessories provide you with convenience and limit your inability to do work freehand. 

If you are also looking for premium-quality LVAD apparel, then LVADGear is a perfect choice as they provide all the accessories, including an LVAD bag and wearable accessories like LVAD life vests, tank tops, and medical shorts. A variety of LVAD Heartmate 3 accessories are also available here to make your life more comfortable, safe, and productive.  

What are the benefits of the LVAD Device?

Before going for LVAD implantation, you may need to understand what does LVAD do and what its benefits are. Here are some of the benefits listed:

• LVAD helps in reducing your symptoms associated with heart failure, such as chest pain, swelling, shortness of breath, and fatigue. 
• LVAD helps to perform the function of the heart more efficiently as compared to a weak heart without LVAD.
• Improves other organ functioning by increasing blood supply to each organ, such as the liver, kidneys, lungs, brain, etc.
• Improves quality of life by increasing the capacity to perform activities of daily living.
• Reduces the chances of emergent situations.
• It helps improve your mental health.
• You will be able to walk long distances after LVAD implantation. 

How to assess if LVAD is functioning?

Living with an LVAD? It’s important to know how to check that everything is working fine. After all, it’s a no-joke, it’s your lifeline.  

First things first – make sure that the device is connected to the battery, which is a power source. The device only runs on batteries, so you should keep them charged and connected every time. Now comes the second part, where you need to listen to the sound your LVAD makes, and that should be stable and high-pitched. Any unusual sound or no sound at all can be a sign that your LVAD device is not working properly, and you need to do something about it. 

Now, you may have a concern here about what happens if LVAD battery dies? The controller in an LVAD device is made with smart features and gives you signs when something is not right. If anything happens like your pump stops, or the battery gets low, and a reduced flow of blood, you are going to hear beeping sounds or see warnings on the controller. So, whenever you see those alerts, don’t ignore them. Take action timely otherwise the pump will stop, and that will be a medical emergency.

What is a LVAD procedure?

The procedure of implanting an LVAD has a few steps and is described below:

• You will be given general anesthesia so that you will remain unconscious throughout the surgery.
• Your surgeon will make an incision according to the approach chosen. It can be open surgery or it can be a minimally invasive surgery, which only requires small incisions.
• You will be converted to a heart-lung bypass machine to take over the heart and lung function.
• The LVAD pump is then attached to your left ventricle and the main artery of the heart.
• A driveline LVAD wire is passed through the abdomen to connect the pump to the controller and battery outside the body.
• After completing the procedure, the device is tested, and then the incisions are closed with sutures.

How long does LVAD surgery take?

LVAD surgery usually takes 4 to 6 hours, but it generally depends on your condition before the surgery and the type of surgery performed. You will stay in the ICU for 1 to 2 days and will be hospitalized for 1 to 2 weeks. You will also need training on how to manage the device before going home.

LVAD surgery recovery

After LVAD surgery, you will recover in 5 to 8 weeks. But this time may vary according to the following factors:

• Condition of the heart
• General health of the patient
• Presence of other diseases like diabetes, infection, and lung disease.
• The number of complications that occur after the surgery
• Age of the patient
• Support and counselling
• Participation in cardiopulmonary rehabilitation
• Ability to understand and manage the device

What is the success rate of LVAD surgery, or what is the LVAD heart pump life expectancy?

Although LVAD does not treat the underlying cause of the heart disease, it still has high success rates in improving patients’ symptoms and their quality of life. So, how long can you live with an LVAD? When we talk about LVAD survival rate, about 80 to 85 % of patients survive one year, and around 70 to 75% can live up to 2 years. More than 50% of the patients are alive even after 4 years. The HeartMate 3 device specifically has a high LVAD life expectancy and a high chance of survival rate of 82% at two years. 

What are the complications of LVAD?

Like any surgery, LVAD implantation also comes with risks. But the good news is that the advancement in medical technology and minimal invasive surgery, the chances of complications have significantly dropped. But that does not eradicate the risk completely. It means you need to be aware of what could happen from any of the following

• Infection – one of the most common complications that occurs in the driveline site where the LVAD wire exits the body. But as the surgery involves opening the chest, infection can also spread during the procedure.
• Blood Clots can form and block important vessels, which can lead to life-threatening conditions like stroke.
• Bleeding can also occur during open heart surgery or if the patient has a bleeding disorder.
• Kidney failure can occur, especially if you previously had some issues. 
• Device malfunctioning can also occur, especially after its lifespan. You may need a revision surgery for this. 
• Damaging of red blood cells due to the pumping action of LVAD, especially when the HeartWare device is implanted.
• Right–sided heart failure occurs when the LVAD is implanted, and your right side of the heart may not be able to sync with it.

How can you minimize the chances of complications by following LVAD precautions?

Let’s be honest, LVAD surgery is a big deal and requires a complete lifestyle update. And if you need to manage complications, too, you will be exhausted in no time. Fortunately, here is how you can reduce your risk of complications

Take prescribed medications

Taking prescribed medications is not optional; you must take them at any cost. These may include antibiotics that prevent infection and blood thinners that reduce blood clot formation. Set reminders and make a schedule that works for you.

Take care of your driveline

The driveline site is an area on your abdomen where the LVAD wire exits your body. Here is a golden rule: keep this area clean and dry. Otherwise, it can catch the infection. Be gentle when you change dressings and avoid pulling.

Wear proper LVAD gear

When you wear LVAD-specific clothing, you conceal and accommodate the device securely in place, which reduces the chances of the device shifting and damaging itself through pulling or tugging. So, wearing an LVAD shirt really makes a difference.

Always carry an extra set of batteries with you

This one should be non-negotiable, as your LVAD runs on the batteries. Make it a habit of carrying an extra set of charged batteries and your backup power source wherever you go.

Things to avoid

While you can do most of the things after recovery, there are some things that need to come off your normal list.

• You cannot swim as the LVAD battery, driveline, and controller are not waterproof. 
• Avoid high-intensity physical activities, as your heart is still learning to adapt to the change with the implantation of LVAD. 
• Do not operate electrically operated machines to avoid the risk of electric shock and hence damaging the device. 

Cardiopulmonary Rehabilitation

One of the best things you can do for yourself after LVAD is to participate in cardiac rehab so that you can feel normal again. It will also be beneficial if you are waiting for a heart transplant, as rehab helps prepare your body for the big day.

Stop your physical activity in these situations

It is normal to feel a little tired after engaging in some physical activity, but pay close attention to the situations where you experience dizziness, nausea, excessive sweating, breathlessness, or severe chest pain.

FAQs

Under what circumstances is a left ventricular assist device used?

Indications for LVAD may include heart failure due to cardiomyopathy or congenital heart disease, bridge to heart transplant, and bridge to recovery.

What is a LVAD wire?

An LVAD wire, also called a driveline which is a cable that connects the implanted LVAD pump inside the body to the external controller and power sources.

How long can a heart live outside the body?

A heart can live for 4 to 6 hours outside the body. However, the time can be extended with the help of newer technologies.

Can LVAD patients live alone?

It is not impossible to live alone for an LVAD patient, but it will be better to have at least one caregiver around all the time.

What is LVAD in medical terms?

LVAD is a Left Ventricular Assistive Device that helps the heart to pump blood from the left ventricle to the aorta and then to the whole body.