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  • Heart Assist Pump for Permanent Implantation for Heart Failure

    heartHeart failure is a major chronic condition in the United States, marked by increasing prevalence, hospitalizations, and deaths.
    One type, called left-sided failure, is caused by a progressive failure of the left ventricle—the large, muscular chamber of the heart that pumps oxygen-rich blood out of the heart to the rest of the body. This form heart failure is often treated with medications and/or surgery. One surgical treatment, aheart transplant, can take years of waiting for a donor.
    Patients now have another option called a left ventricular assist device (LVAD). The LVAD is a device that takes over the work of the left ventricle, which may eliminate the need for a transplant. Here is some information on this technology.

    How Does a LVAD Work?

    A heart assist pump, can be permanently implanted in people who:
    • Are not candidates for transplant
    • Do not respond to standard treatment
    • Have a low risk of surviving 1 year
    An LVAD has two tubes attached to an electric pump. The pump is placed in the upper abdomen. One tube goes into the left ventricle and pulls blood from the ventricle into the pump. The pump then sends blood into the aorta (the large blood vessel leaving the heart), thereby doing the work the weakened heart can no longer do. The pump's other tube is directed through the wall of the abdomen to the outside of the body where it is attached to the pump's control system.
    This device is fairly new, but the evidence for its benefits looks promising.

    Study Results

    Some of the evidence for the benefits of LVAD are mixed, depending on how it is used. The outcome is more uncertain if it is used as a bridge to transplantation in patients rather than in patients who are not eligible for transplantation. The survival rate and quality of life is much better in patients who are not eligible for transplant.

    Potential Problems with the Device

    Implanting the device requires major surgery on people who are already seriously ill. Some of the more severe complications may include bleeding that requires additional surgery, infection, stroke, and right ventricular failure. It is also possible to experience problems with the device.
    All this does not mean however, that it is a bad option. Technology in medicine is always improving and it may be something that works for you. If you have severe heart failure, you may want to discuss this option with your doctor.

    RESOURCES

    American Heart Association http://www.heart.org

    Food and Drug Administration http://www.fda.gov

    CANADIAN RESOURCES

    Heart and Stroke Foundation of Canada http://www.heartandstroke.com

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html

    References

    Heart Failure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated December 3, 2012. Accessed December 12, 2012.

    Implantable Medical Devices for Heart Failure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Implantable-Medical-Devices-for-Heart-Failure%5FUCM%5F306354%5FArticle.jsp. Updated August 20, 2012. Accessed December 12, 2012.

    Implanted cardiac devices for heart failure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated December 6, 2012. Accessed December 12, 2012.

    Types of Heart Failure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/Types-of-Heart-Failure%5FUCM%5F306323%5FArticle.jsp. Updated August 20, 2012. Accessed December 12, 2012.

    1/22/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: FDA approves first compact heart assist device. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116881.htm. Published April 21, 2008. Accessed January 22, 2010.

    2/1/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Peura JL, Colvin-Adams M, Francis GS, et al. Recommendations for the use of mechanical circulatory support: device strategies and patient selection: a scientific statement from the American Heart Association. Circulation. 2012;126(22):2648-2667.

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