What is a left ventricular assist device (LVAD)?

A LVAD (Left Ventricular Assist Device) can help a failing heart keep pumping. Check out this video with cardiothoracic surgeon Craig Smith to learn more about how an LVAD works and whether it’s a temporary or permanent solution.

A left ventricular assist device (LVAD) is a mechanical pump that is attached to a person's heart to help the heart pump stronger and get more blood out to the rest of the body. LVADs are pretty significant devices, intended only for the sickest people with congestive heart failure. The purpose of the LVAD is to help the person's heart to meet the demands of the body.

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The assist devices can be used to support either the right or left ventricle. Most commonly the devices are for the left ventricle and they are called an LVAD. Right sided support devices are called an RVAD. There are occasions when both ventricles need support and biventricular devices are necessary and these are called BIVAD. These are total artificial hearts. In this case instead of 2 assist (right and left) are removed and the total artificial heart (TAH) is placed until a suitable transplant can be performed. 

A ventricular assist device is an implantable heart pump that is used to treat heart failure. There are several kinds of ventricular assist devices. The left ventricular assist device (LVAD) is the most common type. A LVAD supports the left ventricle of your heart, the heart's most important pumping chamber. A LVAD is used in two main situations:

• As a bridge therapy to support your heart while you are waiting for a heart transplant.
• As a permanent therapy (also called a destination therapy) for patients with advanced heart failure who are not eligible for a heart transplant -- due to age, certain types of cancer, or other conditions.

A LVAD weighs less than a pound (anywhere from 5 to 14 ounces). In some cases, the LVAD is implanted in the upper abdomen -- just below the heart or just below the diaphragm. In other cases, the LVAD is attached to the heart itself. The LVAD does not replace the heart. It runs in parallel to the heart, helping the left ventricle to pump more efficiently.

A LVAD is small and silent, with a wearable power system that includes batteries and a small computer. Many heart failure patients with LVADs have longer lives, with the ability to do normal activities such as spending time with family, hobbies, driving, and traveling.

When used as a bridge to transplantation, left ventricular assist devices (LVADs) support heart failure patients who are too sick to wait for a donor heart to be located. The LVAD allows the heart to rest, heal, and grow stronger before the stress of transplant surgery. On average, patients remain on a LVAD for four to six months prior to transplantation. If their health permits, they can return home from the hospital during that time and resume limited activities.

Newer devices are currently available and undergoing testing. These devices are smaller and more durable. These smaller devices often times do not require an abdominal component of the surgery.  The entire pump may be placed within the chest simplifying the procedure for a prospective patient. These new smaller pumps utilize an impeller type system (axial flow) and there are currently systems under review that utilize a magnetically suspended system offering a yet further increase in longevity of pump function.

An LVAD (left ventricular assist device) is a mechanical pump that augments the function of the left ventricle—the heart's most critical pumping chamber. These artificial heart devices consist of an electric pump, an electronic control system, and a power supply. The pump is implanted into the upper part of the abdominal wall and is connected to the heart at two points. A tube carries blood from the left ventricle to the pump.

Blood is pumped through a second tube to the aorta, from which it is distributed to all parts of the body, thereby helping a weakened heart circulate blood. A third tube extends to the outside of the body. In this tube are wires that connect the pump to the small controller which can be worn on a belt. The controller is connected to small batteries that are worn on a shoulder holster.

LVAD, or left ventricular assist device, is a type of artificial heart connected to the left ventricle through the aorta. Watch this video with thoracic surgeon Dr. Hiroo Takayama to learn about how the pump propels blood to support the heart.