Comprehensive Guide to LVAD Implantation: Procedure, Risks, and Benefits

The aorta supplies the entire body with oxygen-rich blood. The cells and tissues need a constant flow of oxygen to survive, otherwise it can lead to heart failure and other related conditions. A mechanical pump called a left ventricular assist device (LVAD) is implanted in patients with heart failure. The device facilitates the heart’s lower left chamber, or left ventricle, pumping blood to the aorta and various other regions of the body. It is called a left ventricular assist device because it helps the left ventricle. The number of individuals receiving LVAD devices has increased due to improved survival rates with current models.

A left ventricular assist device’s components are as follows:

• Pump: Connects to the controller and driveline (cable) of the control system.
• Driveline: Travels from the gadget through your stomach’s skin to the controller, a tiny computer located outside your body.
• Controller: The controller provides messages and alarms to assist you in controlling the system.
• Power supply: Rechargeable batteries or a wire that plugs into an electrical socket are used to power the LVAD. Depending on the device, batteries can run for up to 14 hours. You must change the batteries when their power is low.

Who needs an LVAD?

It is sometimes provided to patients waiting for a heart transplant and is used to treat patients with severe heart failure. Those who are not eligible for a heart transplant can also benefit from it. Doctors refer to that as destination therapy.

• Transplant bridge (BTT): The bridge to transplant (BTT) keeps you alive until you can get a heart from a donor. With LVAD, your heart receives assistance, improving your quality of life and reducing symptoms. During your transplant, the gadget is taken out by a surgeon. The duration of time you get LVAD support before receiving a heart transplant depends on several factors, including your body size, blood type, and medical condition.
• Destination therapy (DT): Those with heart failure who are not candidates for heart transplant surgery can receive destination treatment (DT). Medical professionals only consider this for patients who have exhausted all other options (such as prescription drugs, dietary modifications, and cardiac surgeries).

Procedure for an LVAD:

Before- The healthcare professionals will assess you to see if a left ventricular assist device is right for you. There will be multiple tests throughout your medical exam:

• Electrocardiogram or ECG
• Chest radiography
• Blood examinations
• Echocardiography
• Test for metabolic stress
• Cardiac catheterization

Not every patient with heart failure should receive treatment with a left ventricular assist device. An LVAD may not be appropriate for you if you have:

• Diseases related to blood clotting
• Renal failure is irreversible
• Severe liver damage
• Acute lung conditions
• Infections that are untreatable by antibiotics

During-

• Before the procedure, a general anesthetic will be administered to you.
• During surgery, oxygen-rich blood will be circulated throughout your body through a heart-lung bypass machine.
• During the procedure, a ventilator will be used to assist with your breathing.
• To access your heart and install the LVAD, a cut will be made down the length of your chest to split up your sternum. The physician may do a thoracotomy, or left side of the chest incision, depending on the situation.
• After the left ventricular assist device is inserted, the incision will be closed.

A left ventricular assist device must be implanted, which takes four to six hours.

How does the recovery from LVAD proceed?

After LVAD surgery, a patient typically stays in the hospital for 14 to 21 days. The return to your home will depend on your condition and rate of recovery. Some individuals must keep an eye on their blood pressure at home. You will probably be given intravenous medication to thin out your blood and prevent infections following LVAD surgery. Urine from your bladder and fluids from your surgical wounds may be drained by other tubes.

You will be instructed how to operate the device and troubleshoot any emergencies before you leave the hospital. You’ll need to demonstrate that you understand how to operate the equipment. Additionally, you must demonstrate your ability to care for yourself. When needed, you should be given contact information for your healthcare team.

You will also receive guidance for your day-to-day activities, such as:

• Swimming.
• Taking a shower.
• Taking a bath.
• Taking prescription drugs. (This includes any anticoagulants you will have to take following implantation of an LVAD.)
• Following a diet
• When to give a provider a call.

It’s essential to maintain healthy lifestyle modifications both before and after the LVAD implant treatment, including:

• Give up using tobacco products.
• Consume a balanced diet.
• Give up alcohol.
• Avoid using illicit substances.
• Engage in regular exercise. Participating in cardiac rehabilitation is crucial following surgery. Certain activities including swimming, contact sports, and weightlifting can be off-limits to you.

What are the Risks and Benefits of an LVAD?

There is risk associated with every procedure. You will discuss with your provider about the hazards unique to this procedure and how they might be mitigated.

Among the most typical risks are:

• Infection
• Chest pain
• Swelling in the lower body or back
• Shortness of breath
• Redness around the incision point
• Arrhythmias
• Stroke and blood clots (Thrombosis)
• Hemolysis (the breakdown or rupture of red blood cells)
• Failure of the right heart.
• Damage to the kidneys
• Device for left ventricular assistance malfunction
• Breakdown of the pump

Benefits of LVAD Surgery:

For patients with advanced heart failure who are not eligible for heart transplantation or who are waiting for a transplant, left ventricular assist device (LVAD) surgery provides several advantages.

• Enhanced Heart Function: To assist the heart in pumping blood to the body’s other organs, LVADs, which are mechanical pumps, are implanted in the chest.
• Symptom Relief: By increasing blood flow and decreasing congestion in the lungs and other organs, LVADs can help reduce the symptoms of heart failure, including exhaustion, fluid retention, and shortness of breath.
• Hospitalization Reduction: LVAD surgery lessens the need for hospital stays driven by complications of heart failure.
• Increased Survival: When used as a destination therapy or as a bridge to transplantation, LVAD therapy has been linked to higher survival rates for patients with advanced heart failure.

Conclusion

For patients with severe heart failure, LVAD surgery provides several advantages, including as better heart function, symptom relief, increased chances of survival, and the possibility of a bridge to long-term therapy or transplantation. Collaboration between patients, caregivers, and medical professionals is necessary to guarantee effective LVAD therapy management and maximize results.