Artificial pumping device will help patients

Certain health problems can lead to heart failure. These include coronary artery disease, high blood pressure, high cholesterol, diabetes or being overweight. Some patients can develop heart failure due to dilated cardiomyopathy.

Over time, if not treated, these problems can leave the heart too weak to pump well. If the heart fails to pump enough blood into the body, oxygen supply to various organs may suffer resulting in failure of the kidney, liver, and brain.

If an individual is suffering from heart failure the underlying factors need to be treated. Various medicines are available to treat heart failure in the initial stages. However, in the advanced heart failure or end stage heart failure medicines may not help much. A Ventricular Assist Device (VAD) is a blood pump which assists the heart in pumping blood to the body. It does not replace the heart.

This device will be surgically implanted. For patients who are waiting for a heart transplant, a VAD may help them survive until a donor is found. This is known as Bridge-to-Transplantation.

“Some advanced heart failure patients may not be candidates for a transplant because of other diseases or age. These patients may benefit from long-term VAD support. This is called Destination Therapy,” says Dr Suresh Rao KG, Head of Department, Critical Care & Cardiac Anaesthesia, Fortis Malar Hospital. Occasionally, the patient’s heart get better with a VAD – that’s because the pump gives their heart a chance to “rest”. Since VADs help move more oxygen-rich blood, the patients often have more energy than before.

Doctors say that VADs can be placed inside or outside the body. VAD placement depends on the type of heart disease, patient’s body size, and medical condition. The doctor will decide which one is right for you or your loved one. Today’s implantable VADs are smaller and lighter than earlier VADs, making them an option for smaller patients.

Blood flows through a mechanical pump in LVADs. To prevent clotting of blood in the device the patient has to take anticoagulants. Excess anticoagulation may result in brain haemorrhage or bleeding in the stomach. Hence monitoring of the anticoagulation is a must. LVAD is a continuous pump. Hence the patients will not have a pulse.

This makes blood pressure monitoring more difficult. We recommend measuring the blood pressure using Doppler technique. The blood pressure has to be strictly controlled within the recommended limits.

The LVAD works on electricity and the battery provided with the patient has to be regularly charged to prevent any pump dysfunction,” added Dr Suresh Rao.