VADs Prolong Life of Those with Heart Failure

LEXINGTON, Ky. (May 26, 2015) -- Heart failure is a serious health problem in this country, affecting more than 5 million Americans. Many heart problems, including coronary heart disease, high blood pressure, and valvular defects can ultimately lead to heart failure. 

A heart failure diagnosis usually means the heart's pumping power is weaker than normal. Patients with heart failure generally suffer from symptoms like fatigue, breathlessness, and swollen ankles, legs and/or 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 may deteriorate.

Medicines can be an effective option for heart failure patients. But if the heart is very weak, a ventricular assist device (VAD) can be a lifesaver. A VAD is a mechanical device that helps a weakened heart pump blood throughout the body.

VADs have a mechanical pump that is surgically implanted into the heart and is connected to a control unit and battery pack outside of the body. They are different than artificial hearts, which are designed to run all cardiac function and often require the complete removal of the patient's heart. A VAD, as the name implies, assists the patient's own heart.

This technology is very new ­– the newest pumps were approved less than a decade ago. Because modern VADs have a continuous flow of blood, patients with VADs do 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 only pumps to the lungs.

VADs may be used for short-term or long-term use. Patients sometimes have a VAD temporarily until the heart can recover and pump enough blood on its own, but such cases are uncommon. For patients who need a heart transplant, a VAD may be used as a "bridge to transplant," supporting the cardiovascular system while they wait for a donor heart to become available. VADs also help these patients improve their overall health and strength before transplant, which increases the likelihood of a successful procedure.

However, not all patients with heart failure can be treated with a transplant. Donor hearts are rare. VADs, to the contrary, 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.

Dr. Maya Guglin is the medical director of the UK Mechanical Assisted Circulation Program. 

This column appeared in the May 24, 2015 edition of the Lexington Hera;d-Leader.