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Overview

The human heart is the centre of existence. As long as the heart is beating correctly, pumping blood to all the organs properly, the human life exists. Thus, it is extremely critical that this pump goes on beating and pumping as required. But, with age and many other factors the pumping of the heart may slow down. This can lead to multiple complications and problems for the concerned person.

With the multi-fold advancements in medical technology, now there are procedures available that can assist a tired heart pump blood like a normal one. The most common and well known medical procedure to achieve this is to get an LVD Implant. So, what exactly is an LVD implant? We will look into the details in this article.

Before getting into the nitty gritty of the LVD implant heart surgery, it will be helpful to have a basic understanding of the human heart works. In extremely simplistic terms, the human heart is made of four chambers – two atria (left and right; top two chambers) and two ventricles (left and right; bottom chambers). The oxygenated blood flows from the left ventricle to the aorta, which is the main artery supplying blood to the entire body.

 

When the left ventricle is unable to pump enough blood into the aorta, the result is a shortage of oxygen rich blood to the different parts of the body leading to

  • Fatigue
  • Dizziness
  • Palpitations
  • Chest Pain
  • Stroke
  • Death

To avoid these situations, the doctor may consider ways to support your left ventricle, by means of implanting a Left Ventricular Assistive Device (LVAD). The LVAD implant is not a replacement for the heart, but is actually only a support mechanism to help your tired left ventricle.

The LVAD heart surgery involves placing the LVAD in your body (upper part of the abdomen), in such a way that the blood is pulled from the left ventricle into the device. Once the device is full, it pumps the blood into the Aorta. This supports the weak left ventricle, but doesn’t replace it. A tube attached to the device is brought out of the abdomen, through the skin and connected to the controller and batteries. With further advancements in the field, the LVAD implanted devices have now become portable and can help the patient continue with their daily activities.

So is the LVAD implant surgery the final word in open heart surgeries or can be the solution to all problems? Certainly not! The LVAD heart surgery is not the answer to all problems, nor is it applicable for everyone. The candidates for LVAD implant are very carefully chosen, since this is a complex medical procedure and carries its own risks.

Who are good candidates for the LVAD implant?

Every hospital has a screening process for patients who need a LVAD implant. Every case is scrutinised before the decision is taken. Some general rules of thumb are

  • The patient’s heart should be in such a weak condition that a LVAD implant is required
  • The patient’s heart should be strong enough to work with only assistance and not require replacement
  • The patient should be mentally strong enough to undergo the LVAD implant surgery
  • Bleeding during or after the procedure
  • Formation of blood clots leading to stroke or even a heart attack
  • Infections developing in the body, where the tube connects to the power source
It is extremely important to follow the doctor’s post-surgery advice to the last detail to lead a healthier life.

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Once, the initial screenings are done including ECG, EKG, Chest X-Ray, Cardiac Catheterization, Colonoscopy, Mammogram, Dental and Eye Check-up. Then the situation is discussed by a committee including specialist cardiac surgeons, doctors and other members to decide whether the LVAD implant should be taken up.

Generally, the LVAD heart surgery is of two types

1.Bridge to transplant: The LVAD heart surgery is extremely beneficial to patients waiting for a heart transplant. This can help them continue with their routine life till a heart becomes available for the actual transplant. This can turn out to be life saving for people still waiting for a donor.

Sometimes, in extremely rare cases, the patient may not need transplant at all after the LVAD implant as the tired heart recovers with the assistance. This is medically referred to as “Bridge to recovery”.

2.Destination Therapy: For some patients, where the doctors conclude that they are not fit enough for a heart transplant, the LVAD implant surgery becomes the final treatment. This allows them to have fitter lives as opposed to that without the implant.

The success rate of the LVAD implant surgery have been impressive, since so many precautions and checks are undertaken before proceeding for the procedure. Still, like any medical procedure, this is not without its own risks.

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