Left Ventricular Assist Device (LVAD) Implantation

A left ventricular assist device (LVAD) is a durable mechanical circulatory support (MCS) system that helps a weakened heart pump oxygen-rich blood throughout the body. An LVAD consists of a surgically implanted pump and an external controller and power source, which are connected to the pump via a driveline. Once implanted in the heart, the small pump can take over the workload of the left ventricle, which is one of the heart’s two lower chambers.

Tampa General Hospital’s highly acclaimed Heart & Vascular Institute provides comprehensive and patient-centered cardiac care, and our Heart Failure Center of Excellence is home to one of the top MCS Programs in the nation. TGH is also a member of the Heart Hope Consortium of Ventricular Assist Device (VAD) Centers. We offer the most advanced LVAD available for implantation—HeartMate 3™—and we are committed to providing our patients with the safest and most effective options for managing complex cardiac conditions, including acute and chronic heart failure, cardiomyopathy and cardiogenic shock.

When Is LVAD Implantation Considered?

LVAD implantation may be appropriate for a patient with advanced heart failure due to low ejection fraction that cannot be managed with conventional treatments, such as lifestyle changes, medications or a pacemaker. This pivotal technology can be used:

• To address a severe heart condition – By maintaining adequate blood circulation, an LVAD can relieve disruptive cardiac symptoms, such as overwhelming fatigue, shortness of breath and fluid retention.
• As a bridge to transplant – An LVAD can provide temporary circulatory and pulmonary support while a heart transplant patient awaits a suitable donor organ.
• As a bridge to recovery – If a patient is expected to regain normal circulatory function after recovering from heart failure or surgery, an LVAD can provide support in the interim.
• As destination therapy – If heart transplantation is not an option, an LVAD can provide long-term mechanical circulatory and pulmonary support to enhance the patient’s quality of life.
• After a cardiac event – If a patient experiences acute heart failure or cardiogenic shock, an LVAD can stabilize their condition and support their recovery.

How Is an LVAD Implanted?

Traditionally, LVAD implantation has been completed with open-heart surgery. During the procedure, the patient is usually connected to a ventilator and a heart-lung (cardiopulmonary) bypass machine, which temporarily pumps blood while the heart is stopped and adds oxygen to the blood before it is circulated throughout the body. A standard practice in many cardiac surgeries, cardiopulmonary bypass creates a controlled operating environment for the surgeon. To implant the LVAD, the surgeon makes a large incision in the center of the chest, separates the breastbone to access the heart and then places the pump.

While LVAD implantation through open-heart surgery is a successful technique, it typically results in a long and arduous recovery. TGH is one of only a few hospitals in the United States that offers a less invasive alternative known as lateral thoracotomy. Instead of opening the chest wall, our skilled surgeons can make small incisions between the ribs to implant a tiny LVAD pump in the heart. With lateral thoracotomy LVAD implantation, most patients have a shorter hospital stay.

What to Expect With LVAD Implantation

An LVAD candidate can expect a carefully managed process that typically involves:

• A thorough suitability assessment, which may include a chest X-ray, electrocardiogram (EKG), echocardiogram, heart catheterization, blood test and/or stress tests
• A surgical procedure, such as traditional open-heart surgery or less invasive lateral thoracotomy
• A period of recovery and close monitoring in the hospital
• Education on how to care for the LVAD, change the batteries and recognize signs of complications, such as bleeding, infection and device malfunction
• Ongoing follow-up care

LVAD implantation can significantly improve a patient’s heart function and quality of life. However, it is important to understand that an adjustment period and ongoing medical management will be necessary to optimize the benefits of this  therapy. In keeping with our commitment to supporting LVAD recipients and their loved ones, TGH offers the only durable LVAD patient support group on the west coast of Florida.

How Effective Is LVAD Implantation?

Numerous clinical studies have demonstrated the effectiveness of LVAD implantation in extending and enhancing the lives of many individuals with severe cardiac conditions. As such, it is widely considered to be a vital and successful intervention in the management of heart failure, cardiomyopathy and cardiogenic shock.

Benefit From World-Class Care at TGH

Backed by academic medicine through our solid partnership with the University of South Florida (USF) Health Morsani College of Medicine, TGH’s MCS Program is a respected national and international leader in medical research, clinical services and education. If you would like to learn more about LVAD implantation at TGH, please call (813) 844-8220. You can also reach us via email at VADteam@tgh.org.

Candidates for advanced heart failure care can be referred to our Heart Failure Center of Excellence to be evaluated for MCS therapy as part of TGH’s continuum of care. If you would like to refer a patient, please call (813) 844-8220 or click here for our Heart Failure Referral Form. Through continued collaboration and partnership with the referring physician, TGH will help to ensure the best possible outcome and quality of life for the patient.

If you would like to transfer a patient from another facility, please call 1-800-844-7979. Available 24 hours a day, the TGH Transfer Center can assist with a safe and effective transfer.