Prof. Dr Vivek Gupta
Senior Interventional Cardiologist
Indraprastha Apollo Hospitals

Lvad Life Saving Device a Boon for Heart Failure Patients

Heart failure results from the progressive deterioration of the pumping function of the heart because of underlying heart disease like untreated hypertension, heart attacks, coronary artery blockages, and cardiomyopathies (weakened heart muscles). The prevalence of heart failure in India ranges from 1.3 to 4.6 million, with an annual incidence of 1.8 million. With the growing life-expectancy of the population in India, the burden of this problem is bound to rise. The number of people above 60 years of age in India is projected to increase from 10.5 crore in 2011 (8.4 percent of the total population) to 37.6 crore in 2051 (21.6 percent of the total population).

Treatment Options

Many symptoms associated with heart failure can be treated with drugs along with dietary regulations. More severe cases require to be treated with specialized pacemakers (biventricular with internal cardiac defibrillators known as combo device). However, none of these treatments halt the progression of the disease or reverse the disease process. Definitive treatment for such heart failure patients involves heart transplantation/total artificial heart (TAH) and ventricular assist devices (VAD).

Heart transplantation is significantly limited by the unavailability of donor hearts. Similar to cardiac transplantation, a TAH (large, mechanically complex device) is implanted to replace the patient’s native heart and is used in only a very minor subset of end-stage CHF patients. Mechanical circulatory support (MCS), offers a way to improve the circulation of blood throughout the body with a heart pump called VAD. This device will be used more and more for the palliation and treatment of end-stage heart failure. VADs are gaining increasing clinical recognition as a viable long-term treatment option for patients with advanced heart failure. VADs are being used either as an alternative to transplantation (called destination therapy) or as a bridge-to-transplantation for patients waiting for a donor heart.

Ventricular Assist Device

A VAD takes over some or all of the pumping function of the heart. The pump is implanted inside the chest (pericardial placement) of the patient and is connected directly to the heart. The complete system is portable, weighing about 3.3 pounds (1.5 kg). A carrying case may be worn around the waist or carried over the shoulder, allowing the patient to take the system with him, wherever he goes.

Technology Pipeline – Future

The latest technology platform allows for miniaturization without compromising clinical performance. By reducing the invasiveness of the implant procedure, we have the potential to dramatically expand the use of MCS systems, to help a greater population of heart failure patients, and to reach patients at an earlier stage of their disease progression.

The simple design of the VAD system makes it easy to learn and manage for both the patient and their support team. The intelligent interface and supporting diagnostics offer the tools and essential information they need to effectively manage their patients. For patients, the VAD system offers mobility as it is fairly light weight. A pair of batteries provides mobile power for up to 12 hours. Simple plug and play adapters provide mobility at home, in the car. Ease-of-use controller provides clear and actionable instructions in a text-based display. It requires minimal maintenance and no daily system checks, battery calibration, or power module.

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