What is a Left Ventricular Assist Device (LVAD)?
A left ventricular assist device is a mechanical pump for patients suffering from heart failure. It helps the left ventricle, which is the left bottom chamber of your heart, pump blood to the aorta and the other parts of the body.Â
The LVAD cost in India and other countries of the world is expensive, and thus it is important to understand how it works.Â
Working of the LVADÂ
The LVAD has four parts and can be implanted during open-heart surgery. The pump is implanted into the top of the heart, receiving the maximum blood flow. Blood is then delivered by a tube from the device to the aorta. Aorta is the large artery responsible for taking blood from the heart to the rest of the body. The pump works by pumping blood from the left ventricle to the aorta with a continuous flow.Â
The pump is further attached to a driveline and control system. The driveline makes a passage through the device into the skin. It moves in your abdomen to the controller, which is outside your body. The controller operates the pump and sends messages to help you run the system.
How are LVADs Used?
The two ways through which an LVAD can be used are:Â
- Bridge-to-transplant Â
- Destination therapy.
Bridge-to-transplant (BTT)
A bridge-to-transplant therapy helps the patient endure the complications until a donor heart is available. The LVAD mainly assists the heart to have fewer symptoms until it is removed during transplant. The support that the heart patient gets from an LVAD depends on the medical condition, blood type, and body size.
Destination therapy (DT)
When treatment options like medications, heart procedures, and lifestyle changes fail to manage the heart condition, then destination therapy is a good option. The main objective of DT is to ensure the heart’s functioning and improve the quality of life for the rest of life.
The appropriateness of the therapy is based on the medical condition, symptoms, and body size of the patient. For example, destination therapy is not advisable for patients with blood clotting disorders, irreversible kidney disorders, liver diseases, and severe lung diseases.
The LVAD cost in India depends on how the device is installed, considering the medical condition.
The benefits of LVAD
The LVAD increases the blood flow to the body, thus improving the function of the kidneys, liver, brain, and other body organs. It improves the patient’s ability to participate in cardiac rehabilitation activities and allows them to recover fast and get discharged from the hospital. A few benefits of an LVAD are as follows:
- Greater life expectancy
Finding a suitable donor may vary from a few months to a year. The LVAD device supports the heart till that timeÂ
- Better quality of life
The LVAD helps you live a more active and better lifestyle without the fear of heart failure until a suitable donor is found.
- Fewer symptoms of heart failure
Barring the rare cases of an LVAD malfunction, there are very few chances and symptoms of heart failure till the time the heart is supported with an LVAD.
The risks of LVAD
There are various associated with LVAD surgery. A specialized and trained doctor will help reduce the risks specific to LVAD surgery.Â
The most common risks are as follows:
- Blood clots
- Excessive Bleeding
- Right heart failure
- Kidney failure
- LVAD malfunction
Why is LVAD costly?
LVADs improve the quality of life of patients with heart conditions and significantly increase their lifespan. Due to frequent readmissions and follow-up care, the cost of LVADs in India and other countries is expensive.
Cost of LVAD in India
LVADs being an expensive device, the total cost of the two imported brands of LVADs from the US and Germany crosses INR 1.25 Crore inclusive of the surgery. Due to the high population in India, the need is significant, but patients with heart failure have a high death rate because they cannot afford this expensive device.
India is the first Asian country to manufacture LVADs, after countries like the US and Germany. A Chennai-based hospital has recently tied up with Russian scientists to manufacture a mechanical heart pump that is low cost and can be used as an alternative to a transplant. This device will be available at an approximate cost of INR 30 lakh against the expensive device price of about INR 90 lakh.
Conclusion
The state-of-the-art device will reduce the cost of the LVAD in India and make it more affordable for many more Indians. It will decrease the death rate caused due to delays in surgeries. After the procedure, patients need to undergo weekly check-ups, which then become monthly visits with time. The visits make sure your LVAD is working correctly and avoids further risks.
