Heart failure is a serious health problem, affecting more than 5 million Americans. Many heart problems, including coronary heart disease, high blood pressure and valve defects, can ultimately lead to heart failure.
Heart failure diagnosis usually means the heart's pumping power is weak. Typical symptoms of heart failure include fatigue, breathlessness, and swollen ankles, legs and abdomen.
If left untreated, heart function worsens. Fluid builds up in the body, filling the lungs and making it difficult to breathe. The kidneys can shut down, and other organs might deteriorate.
Medicines can be an effective option for heart failure patients. But if the heart is very weak, a ventricular-assist device can be a lifesaver. A VAD is a mechanical device that helps a weakened heart pump blood throughout the body.
A VAD has a mechanical pump that is surgically implanted into the heart and is connected to a control unit and battery pack outside the body. It's different than an artificial heart, which is designed to run all cardiac function and often requires removal of the patient's heart. A ventricular-assist device, as the name implies, assists the patient's own heart.
This technology is new; the newest pumps were approved less than a decade ago. Because modern VADs have a continuous flow of blood, a patient with VADs does not have a pulse — which surprisingly does not affect any major activities. Kidneys and liver often improve on VAD support, and fluid retention in the lungs and the rest of the body dramatically decreases.
These devices are usually installed on the left ventricle, which pumps blood to the entire body, whereas the right ventricle pumps only to the lungs.
VADs can be used for long or short term. A patient sometimes has a VAD temporarily until the heart can recover and pump enough blood on its own, but such cases are uncommon. For a patient who needs a heart transplant, a VAD might be used as a "bridge to transplant," supporting the cardiovascular system while the patients waits for a donor heart to become available.
VADs also help these patients improve their overall health and strength before transplant, increasing the likelihood of a successful procedure.
However, not all patients with heart failure can be treated with transplants. Donor hearts are rare, and VADs are readily available. For most patients, a VAD is a good treatment option that can prolong life by years, improve its quality, and allow them to return to many of their daily activities.
My patients drive and repair cars, paint houses, fish and hunt, run businesses, play golf, and travel across the country and overseas. Most of them would not be alive today without VADs.