Appointments

866.320.4573

Request an Appointment

Questions

800.223.2273

Contact us with Questions

Expand Content

2013 Winter Addressing Advanced Heart Failure LVADS

Heart & Vascular Institute Physician eNewsletter - Winter 2013

About Advanced Heart Failure LVADs

"Left-ventricle assist devices (LVADs) are another tool in the cardiologist’s armory for a growing number of patients who qualify," says Maria Mountis, DO, Medical Director of Mechanical Circulatory Support at Cleveland Clinic. Once a crutch for heart failure patients waiting for transplant, today’s mechanical circulatory support devices are smaller, stronger, quieter and a stand-alone treatment.

“The field of mechanical circulatory support has grown remarkably in the last decade, giving more patients access to ventricular assist devices for destination therapy or as a bridge to transplant,” Dr. Mountis says.

What's New About LVADs

While the technology has been around for decades, the size of first-generation devices has been a limiting factor for qualifying patients. Early LVADs were bulky and not as durable as today’s “continuous flow” models that are about the size of a D battery.

“It’s important for referring physicians to know that the latest devices are smaller and can be implanted in patients with smaller frames, such as women and children,” Dr. Mountis says, relating that most patients with advanced heart failure are candidates for LVADs.

“You’d be surprised how patients turn around,” Dr. Mountis says. LVADs can help return normal blood flow to the body, and patients may achieve pre-heart failure baselines. “Patients are returning to work, and getting back to hobbies,” she says. “Most of the time, you don’t know a patient has an LVAD. They are able to do essentially everything a patient without heart failure can do.”

Current Indications for LVADs

Currently, the indications for ventricular assist devices as approved by the FDA and insurance companies are for bridge to transplant or destination therapy. Patients who have contradictions for transplant (smoking, pulmonary hypertension, excess weight) must be managed prior to being considered a candidate can get an LVAD to support their heart as they focus on those other health goals. Without an assist device, a patient could deteriorate while waiting on the list. “An LVAD is implanted for a period of time so they can feel better until the time of transplant,” Dr. Mountis says.

But LVADs also can serve as a permanent solution in destination therapy. Some patients are too old for transplantation, or present with comorbidities that preclude them from being a candidate. Or, their heart might be very sick, but not sick enough for transplant. “Some patients simply decide they don’t want another surgery [after the LVAD], and they are happy living with the device,” Dr. Mountis adds. “They feel better.”

LVADs could actual help heal a weak heart. Some European studies suggest that LVADs could be used temporarily to assist the heart and promote recovery. Then the device could be removed.

“While the technology isn’t new, it is gaining much attention and taking cardiology to another level where we can offer these devices as an option for very sick patients,” Dr. Mountis says.

 

Talk to a Nurse: Mon. - Fri., 8:30 a.m. - 4 p.m. (ET)

Call a Heart & Vascular Nurse locally 216.445.9288 or toll-free 866.289.6911.

Schedule an Appointment

Toll-free 800.659.7822

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

© Copyright 2014 Cleveland Clinic. All rights reserved.

HealthHub from Cleveland Clinic

Read the Latest from Our Experts About cctopics » Heart & Vascular Health
High Blood Pressure? Don’t Take Vitamin D for It (Video)
11/20/14 8:31 a.m.
Sellers of vitamin D claim the nutrient can lower your blood pressure. But don’t believe the hype. Despite claims from the nutrition industry and non-medical personnel abou...
by Steven Nissen, MD
When Your Heart Stents Narrow, Brachytherapy Can Help
11/19/14 8:22 a.m.
Cardiac stents are an effective, nonsurgical way of holding a narrowed or blocked artery open to increase blood...
A Post ER Follow-Up Could Save Your Life
11/17/14 8:39 a.m.
Even if Emergency Room doctors say you didn’t actually have a heart attack, that doesn’t mean you h...
Recipe: Low-Fat Crunchy Pumpkin Pie
11/14/14 7:00 a.m.
This low-fat crunchy pumpkin pie uses only a small amount of oil in the crust and skim milk in the filling to m...
Varicose Veins: Not Just an Older Woman’s Problem
11/13/14 8:13 a.m.
You might think of varicose veins as an older woman’s problem, but it may actually have more to do with your li...