Left Ventricular Assist Device (LVAD)
A Left Ventricular Assist Device (LVAD) is a mechanical pump that circulates blood throughout the body when the heart is too weak to pump blood adequately on its own. It is sometimes called a heart pump, but mostly commonly it is referred to as an LVAD (pronounced “el-vad”).
Left Ventricular Assist Device (LVAD) Overview
The LVAD Program at MercyOne is committed to providing outstanding patient-centered care for people with advanced heart failure. It includes a highly skilled team of surgeons, cardiologists and LVAD nurse coordinators from the Iowa Heart Center, in addition to staff nurses, operating room personnel, rehabilitation specialists and many other professionals.
Evaluation Process
Because the LVAD implantation is a major surgery, an extensive evaluation is completed to ensure an LVAD is the best treatment for each patient. This evaluation may include:
- Echocardiogram
- Electrocardiogram (EKG)
- Chest X-Ray
- Chest CT Scan
- Abdominal Ultrasound
- Cardiac Catheterization
- Bloodwork
- Consultations with our specially trained Social Workers and Palliative Care Team
- Up-to-date health maintenance such as colonoscopies, mammograms, pap smears and dental evaluations
- Any additional testing deemed appropriate based on a patient’s individual care plan
If, after an evaluation has been completed, the LVAD team determines that an LVAD is the best treatment option for a patient, a surgery date will be scheduled.
In some cases the LVAD is used to support a patient’s heart and improve their quality of life permanently. This is called Destination Therapy. In other cases the LVAD may be temporary while the patient awaits heart transplant. This is called Bridge to Transplant. The LVAD team will assess each patient individually and recommend the appropriate approach. If transplant is deemed a suitable long-term goal, the LVAD team will refer a patient to a heart transplant program. The Iowa Heart Center has excellent working relationships with many neighboring heart transplant centers and will work together with these partners to provide the best approach for each patient.
LVAD Implantation
The LVAD is surgically attached to the left ventricle (the main pumping chamber of the heart) to the aorta (the main artery that carries oxygenated blood from the heart to the rest of the body). The pump supplements blood flow and restores a strong circulation throughout the body, enabling the patient to breathe more easily and feel less fatigued. The LVAD surgery is often an open-heart surgery or done through the ribs and can have serious risks. However, an LVAD is often a lifesaving treatment for a patient with advanced heart failure
This video describes the LVAD placement: https://youtu.be/T37WrT-lDhQ
LVAD Recovery
A patient should expect to be hospitalized for a minimum of two to three weeks to recover after LVAD surgery. This includes at least one week in the Intensive Care Unit (ICU).
After discharge from the hospital, a new LVAD patient should expect a full recovery over the next three to six months before feeling back to their baseline. All patients recover at different rates, and the LVAD team at MercyOne will tailor treatment to each individual patient. Some patients will stay at an Acute Rehabilitation Hospital for a few days after discharge to work with Physical Therapy before they return home.
Each patient will be offered Physical Therapy and Occupational Therapy before discharge from the hospital. Based on these assessments, the LVAD team will determine if a patient will benefit from these therapies on an outpatient basis. If so, the LVAD team will work with the patient to provide these services. The LVAD patient will also be visited by a Home Health Nurse to ensure their medications are in order and their surgical sites are healing, as well as have bloodwork drawn as needed.
Life with an LVAD
Because the LVAD is a continuous mechanical device, it requires constant power supply. For this reason, there are components implanted surgically as well as components worn outside of the body. The patient and their caregiver are trained in how to take care of this equipment and work with our specially trained LVAD team to receive individualized care.
Life with an LVAD can come with potential risks such as stroke, infection, bleeding and device malfunctions. The benefits of the LVAD include considerable improvement in a patient’s heart failure symptoms and improved quality of life.
LVAD patients are seen frequently after implantation, about once a week after discharge in the beginning. As the patient recovers the visits reduce in frequency until the patient is being seen approximately every three months. LVAD patients will be seen every three months as long as they remain on LVAD support, so the LVAD team can continue to provide the special care that the patient and the equipment require. The LVAD patient will remain in close contact with the VAD Coordinator and the LVAD physicians to ensure the patient is confident, comfortable and safely caring for their LVAD. MercyOne offers special support groups for LVAD patients and their caregivers each quarter.
MercyOne is the only hospital in central Iowa to offer this specialized therapy. For more information about LVADs, contact the VAD Coordinator at (515) 633-3770.