When suffering from serious heart failure, some patients get to a point after a long disease process at which the treatment method with drugs reaches a “dead end”.
The heart is so sick by then and has already lost so much of its pumping strength that the patient starts to accumulate fluid around the heart, abdomen, legs and elsewhere in the body. The other organs, such as liver, lungs and kidneys, are suffering because of it and its functioning is impaired. There is an increasingly larger risk of life-threatening arrhythmias. The patient no longer has energy and strength, breathing takes more effort and the appetite disappears. The patient becomes malnourished, in short, it goes from bad to worse.
Depending on the severity of the complaints, the cardiologist estimates the need to intervene. When there is no time to wait for a donor heart, the patient may be eligible for a ventricular assist device.
The Left Ventricular Assist Device, also known as LVAD
(YouTube video with sound)
A ventricular assist device is a pump that is placed into the human body and forms a connection between the left ventricle and the body’s largest artery. It ensures for the body to receive sufficient flow of blood again.
The pump runs on electricity and is connected with a cable that leaves the body through the abdominal wall.
The cable is connected with a controller which, in turn, is connected to batteries. The patient has to ensure that the device always has sufficient power supply; through the (charged) batteries or the electricity grid.
When you wait for a donor heart…
In order to be eligible for an LVAD placement, a careful procedure will be followed. Examinations have to be conducted to screen the patient. This is the way in which it is determined whether the heart is suited to be supported by a pump and whether the patient is not suffering from any underlying diseases.
During the entire preliminary phase of the disease process, the patient is expected to have shown a conscientious attitude regarding the intake of drugs. It is further of importance that he/she has a social safety net.
An invasive surgery has to be performed in order to place a ventricular assist device.
After the surgery, the patient remains on the Intensive Care (IC) for some time, connected to all kinds of wires and hoses. This includes, for example, artificial respiration, tube feeding, catheter, drains to dispose of the moisture and a wide range of infusions for measurements and the administration of the drugs.
From the IC, the patient will be transferred to the nursing ward where the condition is restored to normal as much as possible again by means of physiotherapy.
The patient is also taught how to handle the equipment of the LVAD, the way in which the wound should be cared for and what action to take when an alarm sounds.
The next step is the return home to recuperate, to build condition and to start a “new” life.
For many patients this Left Ventricular Assist Device forms the final therapy: it means they can or must choose to live as long as they possibly can with an LVAD. Thousands of ventricular assist devices have been implanted until this day… all of these people would not have survived otherwise.
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