A Bridge to Transplant
In the U.S., the median wait time for a heart transplant is nearly 8 months and is growing longer due to a shortage of donor organs. The use of implantable heart pumps known as “Bridge to Transplant” therapy is often necessary for advanced heart failure patients who are at risk of passing away before a suitable donor becomes available.
What is an LVAD?
LVAD stands for Left Ventricular Assist Device (LVAD). It is a mechanical heart pump that will help the left side of your heart pump blood, nutrients, and oxygen to the rest of your body. This will relieve your heart failure symptoms and give you additional energy, stamina, and a better quality of life. An LVAD does not replace your heart.
Implanting an LVAD requires open heart surgery. After surgery, patients are connected to equipment both inside and outside the body. The LVAD must always be connected to a power source. That means you must carry batteries with you. At night you’ll connect the LVAD to a stationary unit for power.
Our center currently implants two types of LVAD devices, as well as a Total Artificial Heart, as a Bridge to Transplant.
HVAD Pump (HeartWare)
The HeartWare HVAD Pump is a miniaturized left ventricular assist device (LVAD) placed directly into the heart. Blood from the left side of the heart flows into the pump. Inside the pump, an impeller helps propel the blood through a tube sewn to the aorta where it then flows to the rest of the body. The HVAD weighs 5 ounces and is the size of a D cell battery. Because of its small size, the pump may be implanted in small adults and adolescents. Patients with the HeartWare device are sent home with a silent wearable power system and must make a commitment to care for the batteries, equipment, and driveline exit site until they receive a heart transplant.
HeartMate 3 (Abbot)
The HeartMate 3 is a small, silent LVAD. During open heart surgery, the pump is placed directly on the heart. Blood from the left side of the heart flows into the pump. Inside the pump, an impeller helps propel the blood through a tube sewn to the aorta where it then flows to the rest of the body. Patients with the HeartMate 3 go home with a wearable power system and must make a commitment to care for the batteries, equipment, and driveline exit site until they receive a heart transplant.
Total Artificial Heart (SynCardia)
In rare cases, some patients with severe right and left-sided heart failure receive a Total Artificial Heart as Bridge to Transplant. The SynCardia Total Artificial Heart is an air-driven pump that completely replaces the patient’s native heart. The pump is driven by a console that provides compressed air in pulses to power the artificial heart. After implantation of the Total Artificial Heart, patients are required to live in the hospital until they receive a heart transplant. Wait times for patients with a Total Artificial Heart vary from days to months.
Surgery
Before undergoing surgery to implant the bridge to transplant device, you will need to be in the best possible physical condition. Implantation of the LVAD involves open-heart surgery. Length of surgery can vary from about six to twelve hours, depending on whether you require other cardiac surgical procedures.
How long will I be in the hospital?
A typical length of stay following LVAD implantation is about three weeks, with two weeks being spent in the Thoracic Intensive Care Unit (TICU) and one week on the Cardiovascular or “Step Down” unit.
Returning home with an LVAD
Before you are ready to leave the hospital and go home, you need to make sure you have a 24-hour caregiver available to help care for you. This can be a family member, spouse, or other loved one. If you live far from Intermountain Medical Center, you may temporarily stay at the hospital's nearby "LVAD apartments" until you are ready to travel home.
When you leave the hospital, our team will arrange home equipment and training with your doctor and interested family members.