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LVAD Implantation Surgery for Heart Failure

Low Cost Left Ventricular Assist Device Implantation Surgery in India|HealthcaretripIndia

LVAD Implantation Surgery for Heart Failure

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Left Ventricular Assist Device, LVAD implantation has proved to be a blessing in patients with end-stage heart failure. It has managed to prolong the life of a heart failure patient by almost 13 to 15 years.

 

In LVAD surgery, LVAD assists the heart in pumping blood to the rest of the body thereby improving blood circulation and oxygen supply to the vital organs. Left Ventricular Assist Device may be implanted as a temporary solution in an advanced heart failure patient, till heart transplant can be done or may even be used permanently for a patient in whom heart transplant cannot be done due to certain limitations.

Under such circumstances, when heart transplant is contraindicated, LVAD implantation is the only viable treatment choice.

Heart surgeons across the world have used VADs (Ventricular Asist Devices) successfully for advanced heart failure patients awaiting heart transplant, as BTT (Bridge to Transplant) therapy.

 

There are several types of VADs. FDA has given its approval to Heartmate 2, HVAD and Heartmate 3. Your cardiac surgeon will determine the type that will be best for you keeping certain factors into consideration.

 

It goes without saying that the doctor and the hospital you would choose will determine the outcome for you in terms of survival and quality of life throughout, given your complex case that calls for specialized medical care. Under such circumstances, even small differences in the quality provided are significant and cannot be overlooked.

Here, HealthcaretripIndia will come handy. We have done an in-depth research on the doctors who have the required qualification, training, skill set and experience to deliver the best results and also the best heart hospitals across India with the most advanced technology, infrastructure and that provide comprehensive services to serve your medical needs.

 

Timely referral of the patient for either Heart transplant or LVAD implantation is a key factor in bringing out favorable outcome for the end- stage heart failure patient.

 

In general low cardiac output syndrome is an indication to think on terms of heart transplant and LVAD implantation requirement for the patient, of course barring some exceptions.

 

Plan your LAVD Implantation Heart Surgery in India with HealthcaretripIndia

 

 

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Q1 What is a LVAD?

 

A1 Left Ventricular Assist Device, full form of LVAD, is a surgically implanted mechanical pump with the size that of a palm of the hand, attached to the heart, precisely Left lower chamber of the heart (Left Ventricle).

 

The LVAD is implanted through Open heart surgery.

 

LVAD has 4 basic components: 

 

  1. Actual Pump or Pump unit which is surgically implanted in the chest, precisely the apex of the heart, where it receives the blood. A tube is attached to it which carries blood from LVAD to Aorta (the largest artery or blood vessel that carries the oxygenated blood from the heart to the rest of the body). It pumps blood continuously from Left lower chamber of the heart to the Aorta.

  2. Driveline or Cable that connects the pump unit (inside the body) to the controller (small computer or control system placed outside the body) through the skin of your abdomen. 

  3. Controller, as the name suggests, it controls the functioning of the pump and helps you operate the whole system, by sending you messages and alarms, as needed.

  4. Power source: Rechargeable battery or cord that can be plugged into the electrical socket to keep the pump working continuously.

 

LVAD has a cable (Driveline) that connects it to a chargeable battery unit placed outside the body. It helps the heart in its function by continuously propelling circulation of the blood with force, throughout the body.

 

Therefore, the patient with an implanted LVAD does not have a pulse, or heartbeat or even a measurable blood pressure.

 

There are two external components of this device i.e., a controller and a chargeable battery unit which makes it work.

 

 

Q2 Is LVAD same as an artificial heart?

 

A2 No. An artificial heart replaces the failing heart entirely. However, LVAD, Left Ventricular Assist Device, is attached with the heart to help it function well without much effort required on its part. LVAD does not replace your heart or takes its place instead. It continuously takes blood from the left lower chamber of the heart and push it further into the aorta which then takes that oxygenated blood to the rest of the body. It augments the pumping action of your heart by working alongside it.

 

 

Q3 What are the attributes of a LVAD?

 

A3 Lightweight small mechanical device, with the size that of the palm of the hand, unlike the attributes of previously available models. The patient is able to move around easily with the implanted device. It has two types of components: Internal and External 

 

Internal pump is placed over or near the left lower chamber of the heart and connected with a tube to the Aorta to propel blood from left ventricle to Aorta.

 

A cable or wire connects the internally placed actual pump through skin of the abdomen, to externally placed controller and chargeable battery unit that powers the pump.

 

The connections amongst pump-controller-power source should be intact throughout for the efficient working of the pump and also it needs to be power packed with the help of the battery or electricity at all times.

 

 

Q4 When is LVAD recommended?

 

A4 The basic purpose for which LVAD is put to use, can be either of the two ways:

 

Bridge-to-transplant (BTT) wherein LVAD is used for patients who are waiting for Heart transplant. Waiting for the heart transplant invariably worsens the medical condition of the patient putting other vital organs also at risk. So, to avoid that situation, LVAD is advised for such patients until they find the suitable donor heart for enhancing survival prospects. When LVAD is used for this purpose , it is referred to as Bridge to Transplant therapy (BTT).

 

LVAD helps the failing heart by working alongside it, it not only mitigates the heart failure symptoms to a large extent, but enhances patient's quality of life also.  LVAD in BTT therapy is eventually removed when Heart transplant is feasible.

 

Destination Therapy: Left Ventricular Assist device can be used for heart failure patients as a destination therapy which means that LVAD will be implanted permanently for the entire life of the patient. It is reserved for those patients for whom Heart transplant is not viable.

 

Heart failure patients who have not responded well to any other treatment option such as medicine therapy, life style modifications, other heart procedures and cannot undergo Heart transplant either.

 

The objective of LVAD destination therapy is to augment patient's heart function, increase patient's survival prospects and allow him to have a better quality of life with reduced or minimal symptoms for the rest of his life.

 

Your cardiac surgeon will determine if LVAD can be used for you and if yes, in which way can it be utilized to give you maximum benefit.

 

 

Q5 What are the contraindications for LVAD as destination therapy?

 

A5 In patients who have blood clotting disorder, irreversible kidney failure, other serious health issues such as advanced liver or lung disease, or infections that cannot be treated with antibiotics, are not the right candidates for LVAD as destination therapy.

 

 

Q6 Which is better a heart transplant or LVAD implantation surgery?

 

A6 Heart transplant, if feasible, is a preferred choice. Currently, Heart transplantation is the definitive therapy for patients with end-stage heart failure for better quality of life and prolonged survival. However, there is supply demand mismatch keeping in view the staggering number of patients with advanced heart failure and the availability of donor heart.

 

In absence of Heart transplant option, LVAD implantation will prevent worsening of the condition, reduce the heart failure associated symptoms and ensure a better quality of life along with prolonged survival of the patient.

 

Heart transplant has its own setbacks such as managing an immunosuppressd patient with transplanted heart involves long term follow up and careful monitoring which puts a socioeconomic burden on the patient and the family. Disadvantages of heart transplant may be rejection, infection, lymphoproliferative diseases, frequent need for endomyocardial, biopsies, graft arteriosclerosis, and transplant coronary artery disease. 

 

In contrast to heart transplant patients, patients with LVAD implantation are not immunocompromised.

 

 

 

Q7 What are the contraindications for both Heart transplant and LVAD implantation?

 

A7 Both heart transplant and LVAD implantation are contraindicated, if the patient has the following medical conditions such as

 

  • Cirrhosis of liver

  • Systemic disease

  • Cancer with poor prognosis

  • Psychiatric illness

  • Financial restraints

  • Poor social condition

Q8 What comes under evaluation for a patient with advanced heart failure for deciding on need for LVAD implantation?

 

A8 Thorough evaluation is carried out by the specialist before reaching a conclusion whether the patient requires LVAD implantation or heart transplant. Clinical assessment, certain blood test, imaging, Right heart catheterization and if other therapies have proved futile in controlling the medical condition of the patient. Thereafter, the cardiac surgeon will decide the best treatment option for you.

 

 

Q9 What is the outcome of LVAD Implantation surgery for Heart failure patients?

 

A9  Timely referral is the key factor in determining the outcome of LVAD implantation or even heart transplant, for the patient with advanced heart failure. 

 

 

Q10 How long is the LVAD surgery?

 

A10 Usually, it takes 4 to 6 hours to perform LVAD surgery.

 

 

Q11 What type of anesthesia is given to the patient undergoing LVAD surgery?

 

A11 LVAD surgery is done under General anesthesia where the patient is put to sleep.

 

 

Q12 How is LVAD surgery done?

 

A12 Patient is given General anesthesia in which the patient is put to sleep for the entire duration of the surgery that lasts for around 4 to 6 hours.

 

Open surgery is required to implant Left Ventricular Assist Device. An incision is made centrally and vertically down in the chest. Your chest bone, referred to as Sternum in medical parlance, is pulled open to access your heart and implant the mechanical circulatory device, LVAD at the apex.

 

Alternatively, your surgeon may choose to make an incision on the left side of your chest to implant the device.

 

During surgery, a heart-lung bypass machine may be used to supply oxygen rich blood to the entire body and  and ventilator to take over breathing. Once the LVAD is implanted, incision will be closed.

 

 

Q13 How long is the hospital stay for LVAD surgery?

 

A13 Response to the surgery and recovery span varies with each patient. However, for most of them the hospital stay would be from 2 to 3 weeks.

 

 

Q14 What are the advantages of LVAD?

 

A14 Benefits of LVAD implantation in the patient with advanced heart failure are:

 

  • Increased life expectancy

  • Better quality of life

  • Minimal symptoms of heart failure

  • Improved the efficiency of other oragans

  • Help Restore blood flow in advanced heart failure patients

Reduced need for frequent hospitalization, able to do a number of activities which were impossible earlier and feel better as smptoms of heart failure have significantly reduced.

 

 

Q15 What are the potential risks and disadvantages associated with LVAD implant?

 

A15 Though rare, the risk associated with LVAD implantation may be:

  • Infection

  • Pump failure
  • Thromboembolic event

  • Disadvantage may be of device durability and its cost.

 

LAVD Implantation Heart Surgery in India 

 

  • High quality treatment at the most affordable cost.

  • High success rate with outstanding results 

  • World class hospitals with state of the art infrastructure.

  • No waiting period

  • Globally trained and highly experienced Cardiac surgeons in carrying out the procedure with competence and ease.

  • Great ambience

  • Compassionate staff to look after

  • Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

  • Language no barrier. English speaking people and if required, translators are available for your convenience

  • Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service apartments to five star hotels, best suited to your budget and choice.

  • Good flight connectivity

  • India has a diverse and rich cultural heritage. You can witness its beauty and uniqueness. It offers most conducive environment for recuperation.

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Top Cardiac Surgeons of India|LAVD Implantation Surgery 

 

 

Dr Kewal Krishan

MBBS, MS (General Surgery), MCh (CTVS), DNB (CTVS)

Director, Heart Transplant and LVAD program

Cardiac Sciences, Cardiac Surgery (CTVS)

Max Super Speciality Hospital, Saket, New Delhi

Dr Rajnish Malhotra

MBBS, MS (General Surgery), MCh (CTVS)

Principal Director, Cardio Thoracic and Vascular Surgery

Max Super Speciality Hospital, Saket, New Delhi

Cardiac Sciences, Cardiac Surgery (CTVS)

Dr Ajay Kaul

MBBS, MS (General Surgery), MCh (Cardiothoracic Surgery)

Chairman, Cardiac Sciences,

Fortis Hospital, Noida

Dr Y. K Mishra

MBBS, MS (General Surgery), PhD (Cardiothoracic and Vascular Surgery)

Head of Cardiac Sciences and Chief Cardiovascular Surgeon

Manipal Hospital, Dwarka

Dr Bhabha Nanda Das

MBBS, MS (General Surgery), MCh (Cardiothoracic Surgery)

Chief Cardiothoracic Surgeon

Apollo Hospital, Delhi

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