There are two types of patients who get left ventricular assist devices. The first is someone we are trying to keep alive while he or she is waiting for a heart transplant.
The duration of time between implantation of left ventricular assist device and when a person gets a heart transplant varies based on a number of factors, the most common being weight and blood type. A more common the blood type means more people on the transplant list and a longer wait time. A rarer blood type means there are fewer people on the transplant list so the waiting time tends to be shorter.
The second type of patient is someone who is not a candidate for transplant, the main reason being age at the time of the implant. Patients ineligible for transplant may be a candidate for destination therapy, which means the goal is not to get to a new transplant but rather to improve quality of life and to improve survival with a left ventricular assist device.
Dr. Fonarow explains that, in many cases, having a ventricular assist device is equal to or better than getting a new heart because people after a transplant have to be on a number of medications to prevent rejection, and they need regular biopsies. The disadvantages, of course, relate to needing a battery pack and making sure the power for the device doesn’t run out. There are risks of serious infections or blood clots forming, and of the pumps failing.
However, Dr. Fonarow says that, in some cases, people who receive the newest-generation VAD find that their quality of life has improved to the point that they no longer desire a new heart. However, a heart transplant still is the ideal therapy.
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