This content has been prepared for informational purposes to protect public health, in compliance with the regulations of the Ministry of Health of the Republic of Turkey and medical ethical rules. It does not provide any diagnosis, treatment guarantees, or specific medical advice. Please consult a qualified healthcare provider for the most accurate information.
LVAD (Left Ventricular Assist Device) is a mechanical device that supports or completely takes over the heart’s pumping function in advanced heart failure. It is used as bridge therapy in patients waiting for heart transplant or as permanent treatment in patients not suitable for transplant. In this guide, we detail how LVAD works, who it is applied to, and how it affects daily life.
What is LVAD?#
LVAD (Left Ventricular Assist Device) is a mechanical device that takes blood from the left ventricle and pumps it to the aorta. It helps provide adequate blood flow to the body by reducing the load on the weakened heart.
Modern LVADs are continuous flow pumps and do not create a pulse like traditional heartbeat. Therefore, LVAD patients may not have a detectable pulse or it may be very weak - this is completely normal.
LVAD Components:
- Pump: The main unit placed inside the heart (at the left ventricular apex)
- Driveline: Power cable exiting the body from the pump
- Controller: Computer unit that manages pump operation
- Batteries: Portable power source (usually 2)
Who Receives LVAD?#
Bridge Therapy (Bridge to Transplant)#
In patients waiting for heart transplant, it helps them survive until a suitable donor is found:
- Bridge to heart transplant
- Bridge to recovery (heart may improve in some patients)
- Bridge to decision (patients with uncertain transplant eligibility)
Destination Therapy#
As a permanent solution in patients not suitable for heart transplant:
- Patients who cannot undergo transplant due to advanced age
- Those with contraindications due to comorbidities
- Patients requiring permanent mechanical support
Patient Selection Criteria#
- End-stage heart failure: NYHA class IV
- Ejection fraction <25%: Severe pump weakness
- Symptoms despite maximal medical therapy
- Inotropic dependence: Inability to survive without medications
- Recurrent hospitalizations
LVAD Contraindications#
Absolute Contraindications#
- Severe right heart failure (LVAD only supports the left heart)
- Irreversible multiorgan failure
- Active, uncontrollable infection
- Severe bleeding disorders (coagulopathy)
Relative Contraindications#
- Very advanced age
- Severe kidney failure
- Liver failure
- Psychosocial problems (risk of non-compliance with device care)
- Aortic valve disease
LVAD Surgery#
Preoperative Preparation#
- Comprehensive evaluation: Control of all organ functions
- Right heart evaluation: Whether the right ventricle can withstand LVAD
- Nutritional status: Protein and vitamin levels
- Psychosocial evaluation: Family support, compliance capacity
- Education: Informing patient and family about the device
Surgical Technique#
- Sternotomy: Chest bone is opened from the middle
- Cardiopulmonary bypass: Connected for support
- Pump placement: Secured to the left ventricular apex
- Outflow graft: Connection made to the aorta
- Driveline exit: Tunneled through the abdominal wall
Surgery Duration#
Total duration: 4-6 hours
Daily Life After LVAD#
Daily Care Routine#
LVAD patients must follow certain care routines every day:
Driveline Care:
- Daily dressing check and change
- Cleaning of exit site
- Checking for signs of infection (redness, discharge, fever)
Device Check:
- Checking battery levels
- Monitoring alarm conditions
- Observing controller screen
General Care:
- Daily weighing (sudden weight gain is a sign of edema)
- Blood pressure monitoring (with Doppler)
- Regular medication use
Anticoagulation Therapy#
LVAD patients use blood thinners to prevent clot formation inside the pump:
- Warfarin: Target INR 2.0-3.0
- Aspirin: Daily low dose
- Regular INR monitoring: Blood clotting tests
Attention! Do not stop or change the dose of anticoagulant therapy. Pump thrombosis can be life-threatening. Contact your healthcare team immediately if any bleeding occurs.
Activities and Restrictions#
Can Do:
- Walking and light exercise
- Housework
- Social activities
- Travel (including air travel)
- Driving (after recovery)
Cannot Do:
- Swimming or bathing in a tub
- Contact sports
- MRI imaging
- Heavy lifting (for driveline protection)
Showering#
Showering is possible using special waterproof protection. It is very important that the driveline exit site remains dry.
LVAD Complications#
Early Complications (First 30 days)#
- Bleeding: 15-30% rate
- Right heart failure: Right heart may be stressed when LVAD empties the left heart
- Infection: Surgical site infection
- Arrhythmia: Ventricular arrhythmias
Late Complications#
- Driveline infection: Most common complication (20-40%)
- Pump thrombosis: Clot formation inside the pump
- Stroke: Hemorrhagic or ischemic
- Gastrointestinal bleeding: Due to arteriovenous malformations
- Device malfunction: Rare
LVAD Results#
Quality of Life#
In the majority of LVAD patients:
- Shortness of breath significantly decreases
- Exercise capacity increases
- Hospitalizations decrease
- Return to daily activities is achieved
- Depression and anxiety decrease
LVAD vs Heart Transplant#
| Feature | LVAD | Heart Transplant |
|---|---|---|
| Donor requirement | None | Yes |
| Waiting time | None | May be long |
| Immunosuppression | None | Lifelong |
| Infection risk | Driveline | Opportunistic infections |
| Bleeding risk | High | Low |
| Long-term survival | Varies by LVAD | Better |
Frequently Asked Questions#
Is normal life possible with LVAD?
How long do LVAD batteries last?
Can I swim with LVAD?
Is LVAD permanent?
Can I have MRI after LVAD?
Can a person with LVAD feel a pulse?
How is LVAD infection prevented?
Can I fly with LVAD?
Consult a cardiology specialist for LVAD evaluation or detailed information about advanced heart failure treatment.
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