As a candidate for an LVAD, your doctor will likely be putting you through a series of tests to determine suitability before the implant.
Some of the tests and exams include:
- Diagnostic testing such as echocardiogram or right heart catheterisation
- General health screening which includes blood tests and chest X-ray
- Dental and psychosocial exams
Implanting an LVAD involves open heart surgery, so you may need to be admitted a few days beforehand to ensure you are healthy enough for the procedure.
During a left ventricular assist device (LVAD) implantation
Surgery to implant an LVAD takes approximately 4 – 8 hours. During the procedure, you will be placed under general anaesthesia and connected to a ventilator and heart-lung bypass machine to temporarily take over your lung and heart functions.
To attach the LVAD, the surgeon will make an incision in your chest and open the chest bone (sternum). The LVAD comprises of a pump directly implanted into the tip (apex) of the left ventricle of the heart. This pump will deliver blood via tube to the aorta so it can be distributed to the rest of the body. A cable connects the pump to a control unit and battery pack outside the body.
Once the LVAD is properly implanted and tested, you will be taken off the heart-lung bypass machine, and the LVAD will take over and pump blood out of the heart to the aorta.
After a left ventricular assist device (LVAD) implantation
After the procedure, you will remain in the ICU for a few days where you will receive fluids, nutrition and medication intravenously, while other tubes will drain urine from your bladder and fluids from chest and heart. You may need to remain on a ventilator until your lungs are able to function normally.
Recovery period for a left ventricular assist device (LVAD) implantation
Recovery time will vary depending on your health, and after transferring out of the ICU, most patients will need to remain in the hospital for at least 2 weeks.
Living with a left ventricular assist device (LVAD)
Patients living with an LVAD will have to make adjustments to their daily activities. There are some things that you will not be able to do, like swimming, sleeping on your stomach or undergoing an MRI scan. Fortunately, the external parts of the LVAD are getting smaller and batteries are now lighter and longer lasting. You should be able to resume your normal activities by following your doctor’s instructions closely. You will be encouraged to make healthy lifestyle choices and monitor your health closely to ensure that you remain healthy and adapt well to life with the LVAD.
Risk/complications of a left ventricular assist device (LVAD) implantation
While there are risks with every surgery, such as infection, bleeding or blood clots, steps are taken to manage or reduce those risks. After an LVAD implantation, there is the additional risk of stroke, gastrointestinal bleeding and right heart failure. Device malfunction such as power failure or faulty parts that could cause the LVAD to stop working is uncommon.