Heart failure: Heart pumps help keep the beat
When you have heart failure, your heart can't pump enough blood to meet your body's needs. Treatment is directed at the underlying cause, such as high blood pressure or coronary artery disease. Lifestyle changes and medication often help, too. If heart failure progresses, an advanced treatment such as a heart pump may be recommended.
A heart pump takes over the function of one or both of the heart's lower chambers, with the potential to improve your symptoms and quality of life. Once considered a last resort for prolonging life until a donated heart became available, heart pumps have become a possible long-term treatment for selected people with heart failure.
How does a heart pump work?
A heart pump replaces the work of one or both of the heart's lower chambers (ventricles). The pump — often about the size of a personal compact disc player — is implanted in your upper abdomen through open-heart surgery. Blood from the supported ventricle flows through the pump, into the aorta and then to the rest of your body. You'll feel the pump beat beneath your skin. The pump is connected to a battery pack worn outside your body, often in a small shoulder bag or fanny pack.
Some heart pumps are designed to support only the heart's left ventricle. These are known as left ventricular assist devices (LVADs). Other heart pumps support the right ventricle (RVAD) or both ventricles (biventricular assist devices).
A bridge to recovery
Sometimes a heart pump temporarily supports the heart as it heals from a massive heart attack, an episode of sudden heart failure or complications from open-heart surgery. In other cases, a heart pump works along with medication to improve heart function until transplantation is possible. With the help of a heart pump, your heart may even perform at normal or near-normal levels — alleviating symptoms and perhaps eliminating the need for a transplant. Occasionally it's possible to be weaned from the pump until it's no longer needed.
Or sometimes a destination
If your heart failure can't be appropriately managed with medication or special pacemakers and you're not a candidate for a heart transplant, a heart pump may offer promise as a long-term treatment. This is known as destination therapy — an option approved by the Food and Drug Administration in 2002.
When used along with medication, a heart pump doubles the one-year survival rate for people with end-stage heart failure. This remarkable benefit was first noted in a 2001 landmark study in which researchers confirmed the benefits of heart pumps compared with medication alone. A heart pump also improves the signs and symptoms of heart failure — such as breathlessness and fatigue — which can improve your quality of life.
Understand the risks
A heart pump can be a lifesaving treatment. Yet the potential risks are serious, including:
- Infection
- Blood clots
- Stroke
- Bleeding
- Device malfunction
Some complications associated with a heart pump are life-threatening.
Living with a heart pump
Whether your heart pump is a bridge to transplant or your destination, you'll need to adjust to life with the pump.
- Follow the instructions from your medical team. Specific precautions may vary depending on the specific type of pump.
- Take your medication as prescribed. Your doctor may prescribe various heart failure medications, including anticoagulants to help prevent blood clots.
- Anticipate the battery life of your pump. You may need to change the pump's batteries once or even twice a day. Store extra batteries in a cool place.
- Keep it clean and dry. To prevent infection, carefully cleanse the area where the battery wire is implanted. Make sure your battery pack and the wire connecting the pack to the pump stay dry — even when you bathe.
- Avoid magnetic resonance imaging (MRI) exams. These imaging studies use a strong magnet, which may interfere with the pump.
- Watch for mechanical problems. You'll have regular check-ins with your doctor and device technician. Report any changes in the pump's sounds or motion immediately.
- Be prepared for emergencies. Your doctor will provide a hand pump and emergency power pack in case the implanted pump fails. Make sure you and your caregivers know how to use the hand pump.
A heart pump can offer a second chance at life. Work with your doctor to make the most of it.
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