LVAD: Buying Time

It’s hard to believe that someone without a pulse could live a longer, better life. Yet that’s exactly what happens when a nonpulsating mechanical pump, called a left ventricular assist device (LVAD), takes over for a failing heart.

Implantable LVADs have been used at Cleveland Clinic since the early 1990s. Earlier, bulkier versions of this battery-operated device were used to keep patients alive until a heart became available for transplant. Improvements in design and a smaller size led the Food and Drug Administration in 2009 to approve LVADs as a permanent treatment for advanced heart failure.

“A patient with the newest version of LVAD has a one-year survival rate of 70 percent to 80 percent, compared to 55 percent with older, larger versions,” says Randall C. Starling, MD, MPH, Vice Chairman for Clinical Operations in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine.

An LVAD, about the size of a “D” battery, is implanted in the upper abdomen and connected to two rechargeable batteries, which the patient usually wears slung over the shoulder in holsters. An alarm sounds when power is low.

“It’s incredibly rewarding when you see very sick people get better and go home,” says Tiffany Buda, BSN, RN, Clinical Nurse Manager for Heart Failure at Cleveland Clinic’s main campus. “Some of our patients are able to go back to work or to travel.”