At Stony Brook University Heart Institute, we provide a full range of heart failure treatments aimed at helping you manage your symptoms, achieve and maintain the best quality of life possible, and keep you out of the hospital. For patients with advanced heart failure, one option may be an implanted left ventricular assist device (LVAD).
The LVAD program of the Stony Brook Heart Institute — the first and most experienced program on Long Island that provides "destination therapy" — is fully certified by The Joint Commission.
"Accreditation is a seal of approval that signals to our patients that they are in a quality program and are in capable hands when they come to Stony Brook," says Allison McLarty, MD, Surgical Director of the VAD program.
Heart failure occurs when the heart becomes too weak to pump enough blood to meet the body's needs. Your heart is a muscular pump divided into four chambers. The upper chambers are called the atria and the lower chambers are called the ventricles. The left ventricle is your heart's main pumping chamber and is responsible for pumping blood to your body. For some people with heart failure, the left ventricle weakens to the point that it can no longer pump enough blood on its own.
An LVAD is a surgically implanted, battery-powered pump that helps the left ventricle pump adequate amounts of blood to the body. The LVAD is implanted in your upper abdomen and connected to a power supply located outside your body. Blood is sent through a tube in your left ventricle into the LVAD, which pumps the blood through another tube into your aorta and throughout your body. An LVAD can be implanted in people who are candidates for a heart transplant as a "bridge to transplant." Some patients may experience improved heart function while the LVAD is in place, which may make the transplant unnecessary. In patients who are ineligible for a heart transplant, the LVAD can be a "destination therapy," that is, the LVAD is implanted permanently.
What to Expect
LVADs require open-heart surgery for implantation. Once you are asleep, to gain access to your heart, your surgeon will perform a sternotomy, in which he or she makes an incision in your chest and separates your sternum (breastbone). You will then be connected to a heart-lung bypass machine, your heart will be stilled, and the bypass machine will perform the function of your heart while your surgeon performs the procedure. Your surgeon will create a pocket in your upper abdominal wall in which the LVAD will be placed. Your surgeon will then connect a tube from your left ventricle to the LVAD, connect another tube from the LVAD to your aorta, and connect the LVAD to the power source. Once the LVAD is connected, your surgeon will then activate the LVAD and adjust it to ensure it pumps the correct amount of blood. After the adjustments are made, you will be taken off heart-lung bypass, your heart will be restarted, and your incision closed.
Possible Complications
Your surgeon will discuss the possible risk of the LVAD implantation. There is a small risk of complications from this procedure that includes (but is not limited to) infection, bleeding, heart failure, breathing problems, blood clots and stroke or brain damage.
Recovery
After surgery, you will be taken to the intensive care unit (ICU), where your recovery will be monitored. You will have a breathing tube in your mouth to help you breathe until you are awake and able to breathe on your own. You will have several intravenous (IV) lines to give you medication and fluids, and you will also have several drainage tubes in place, which will be removed as you improve and recover. Once your condition is considered stable, you will be moved from the ICU to a regular room. Depending on your specific circumstances, you can expect to be in the ICU for 2 to 5 days and in the hospital for about 2 to 4 weeks. During that time, you and your family members will receive education about how the LVAD functions and how to manage it.
We have a team of nurses, and our support personnel include specialists at the hospital and in your community who will help you with your LVAD. Our commitment is to make sure that you and your family are completely comfortable with the care and maintenance of the LVAD device. We will also provide 24/7 support as well.