In the case of chronic heart failure, a left ventricular assist device, or LVAD, is a mechanical pump implanted below the heart. Blood is pumped from the left ventricle to the aorta and throughout the body through the device. This is usually referred to as “the bridge to transplant”. While patients with severe heart failure will require open-heart surgery in order to implant the LVAD, it is a lifesaving procedure. Certain patients cannot receive heart transplants as part of their “destination therapy”. LVADs can be used for long-term treatment in this instance, allowing patients to prolong and improve their lives.
LVAD surgery is performed at CARE Hospitals in an environment that’s supportive, caring, and compassionate, providing the best quality and advanced technology available. Our doctors across a variety of specialties provide comprehensive, individualised treatment plans.
An LVAD/heart transplant selection committee will evaluate you in order to determine whether an LVAD is the best treatment. This committee may include the following individuals:
Cardiologists who specialise in heart failure.
Physician assistants and nurse practitioners.
Palliative medicine specialists.
Cardiac rehabilitation specialists.
Pulmonologists or kidney physicians.
An LVAD is designed to assist your weakened left ventricle with pumping blood. Portable devices have been made available in recent years instead of bulky machines. While waiting for a kidney to become available, you can continue to live your normal life with the LVAD installed in your body. A number of tests must be performed before an LVAD can be implanted to determine whether you are a good candidate.
Echocardiogram: The aim of an echocardiogram is to quickly and efficiently obtain valuable information about your heart using ultrasound or harmless sound waves. Echocardiograms are often used to determine the size, shape, and operation of your heart and its valves by our doctors.
(VO2) exercise test: Determines how much oxygen your heart and lungs can deliver to your muscles.
Right heart catheterization: Measures the pressure in your heart.
Left heart catheterization: Uses dye to examine your coronary arteries in the left heart.
Electrocardiogram (EKG): A test that records the electrical impulses from the heart. This is used to determine the heart’s rhythm, the size of its chambers, and the thickness of its muscles.
Laboratory tests: Test blood type, organ function, and disease exposure.
Pulmonary function test: Checks whether you smoke or have smoked in the past.
Carotid and peripheral ultrasounds: Detects blockages in certain blood vessels.
Dental exam: To determine your oral health
Insurance clearance: This includes covering the cost of surgery, as well as tests and medications after transplantation
In order to determine if you have a good chance of receiving a heart transplant, your doctors may need to conduct other tests.
In order to determine your candidacy as an LVAD recipient, you will undergo a detailed psychosocial evaluation from an LVAD specialist.
The following things will be assessed:
What do you understand about the LVAD process?
Caregiver availability before and after implant.
Coping and stress management challenges.
Keep up with your current medication regimen.
Your mental health history.
History of Substance use.
After all testing and psychosocial evaluation are complete, your entire LVAD team, including surgeons, cardiologists, nurses, social workers, psychiatrists, financial counsellors, and more, will meet to review your case.
LVAD therapy can be safely and effectively prescribed for you after meticulously reviewing the information that you provide.
Upon receiving the committee’s decision, your cardiologist will inform you of your options if you are not deemed a suitable candidate for an LVAD.
To determine your eligibility for a VAD, you will be tested for your heart function and health. These include chest x-rays, echocardiograms, electrocardiograms (EKGs), blood tests, and cardiac catheterization.
VADs are implanted through open-heart surgery performed under general anaesthesia. You will be completely asleep during the procedure and will not feel anything. The operation will take four to six hours. Following the procedure, you will be taken to the intensive care unit for further recovery. Until you are awake and able to breathe on your own, you’ll be on a respirator, or breathing machine.
The hospital staff will teach you how to maintain and protect the device, and what to do if there is an emergency during your hospital stay. Within a few days of leaving the hospital, you and your care provider will both be experts in your device.
In order to reassure them that you have a VAD, we will communicate with your primary care provider and local emergency services to inform them of your condition and to explain how this affects your care.
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