July 29, 2022

Advanced heart failure and how an LVAD could help

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A left ventricular device helps the heart pump.

Heart failure is a long-term health problem affecting millions of Americans.

In most cases, it is a gradual weakening of the heart, including the heart’s left ventricle, its main pumping chamber. When the left ventricle becomes very weak, the heart can no longer pump the amount of blood needed for the body to function. This is often called advanced heart failure. In cases of advanced heart failure, medicines are often not enough help, and your doctor may talk to you about an artificial pump called a left ventricular assist device (LVAD).

What is advanced heart failure?

Heart failure usually develops over time. In its early stages, patients may not feel any symptoms. But as heart failure progresses, they may start feeling extremely tired and short of breath, especially when exercising or doing something strenuous, such as climbing stairs.

Lifestyle changes and medicine can often help ease symptoms of heart failure and help the heart recover. In some cases, however, the heart may continue to weaken. Over time, patients may develop advanced heart failure. In this state they are often fatigued and short of breath even with light physical activity and sometimes even at rest. Treatments, including medicine, may no longer work well enough. Often, patients with advanced heart failure experience swelling in the legs or other symptoms, and may need a stay in the hospital.

What are the symptoms of advanced heart failure?

With advanced heart failure, daily activities, such as getting dressed, may become difficult. In addition to feeling tired and short of breath, people with advanced heart failure may experience swollen legs, ankles feet and a swollen belly. The swelling is from fluids building up in the body because the heart is weak.

Other symptoms include:

  • Shortness of breath while lying flat or sleeping.
  • Chest congestion or cough.
  • Weight gain because fluid is building up in the body.
  • Poor appetite or a feeling of fullness even after a small meal.
  • Chest pain.
  • Lightheadedness.
  • Heart palpitations or flutters.
  • Abnormal heart rhythms (arrhythmias).
  • Depression.
  • Low blood pressure.

How a left ventricular assist device can help

A left ventricular assist device (LVAD) is a heart pump that is implanted during a surgery. The pump connects to the patient’s heart and takes over some of its pumping function to help blood flow better to the rest of the body. For some patients, LVADs are used while they wait for a heart transplant.  In these cases, the implant is referred to as a “bridge to transplantation.”

In other patients who may not be candidates for a heart transplant, the device is referred to as “destination therapy.” In all cases, the goal is for the implant to help patients with advanced heart failure feel better and live longer.  

Is this device right for you?

If you think a left ventricular assist device could help you, talk to your health care provider about being seen by a doctor who specializes in advanced heart failure. An advanced heart failure specialist can talk to you about whether you may be a good candidate for a left ventricular assist device. They can explain the risks and benefits of these pumps, as well as what life with an LVAD is like.

Living with one of these devices requires a lot of follow-up care and visits to the clinic. You will need occasional checkups and tests. You will also need to make lifestyle changes. Your care team will help you make the transition to living with a left ventricular assist device.

Middle-aged man sitting at a desk looking at his laptop screen in a sunny room.

Vanderbilt University Medical Center has one of the top heart failure programs in the nation with the expertise to care for all stages and causes of heart failure, from the most basic to the most complex. Vanderbilt’s innovative treatments offer hope when you need it most.

 

Download a treatment guide