Implantation of a left ventricular assist device for destination therapy in people ineligible for heart transplantation

The procedure

Implanting a left ventricular assist device (LVAD) involves putting a mechanical pump into the chest near the heart to help, or take over, the pumping of blood throughout the body. It is often used for people who are waiting for a heart transplant. But, in this procedure, an LVAD is being used as a permanent treatment for people for whom a heart transplant is not possible. This is called 'destination therapy'. The open heart surgery to implant an LVAD into the heart takes several hours. It is done under general anaesthetic and the surgeon cuts through the chest wall. An LVAD has 2 pipes: one (the inflow) is inserted into the left side of the heart and the other (the outflow) is inserted into an artery, usually the aorta (the main artery from the heart to the body). The device is then attached by a power cable to a control system and battery worn on the outside of the body. Once it starts working, the LVAD pumps oxygenated blood from the heart into the arteries.

Some people may also need a second LVAD implanted at the same time to support the right side of the heart.