Frequently asked questions

LVAD outcomes and survival

  • Heart failure is a chronic disease that worsens over time despite medications.
  • “End-stage” heart failure has a worse prognosis than many other diseases, including some cancers.
  • While predicting survival is hard, more than half of patients with severe heart failure may die within a year.
  • In carefully selected patients, LVAD therapy can improve survival, quality of life and symptoms such as shortness of breath.
  • Destination therapy (DT) refers to patients who are not eligible for heart transplantation due to age or other illness who undergo LVAD implantation.
  • DT patients will live the rest of their lives with an LVAD, meaning they will be dependent on a mechanical heart pump and an electrical source of energy. This includes batteries or being connected to a power plug at night while sleeping.
  • Battery life can last between 8–14 hours. Patients have 3 sets of batteries, so they can be out of the house for the majority of the day without worrying about recharging.
  • Approximately 4 out of 5 patients will be alive at 1 year. About half of patients are expected
    to live for longer than 4 years.
  • We expect LVAD patients to have healthy and full lives with improvement in symptoms and quality of life — this is why we offer this life saving therapy.
  • Some patients are able to return to work with their LVADs.
  • Travelling is more difficult and requires planning, but is very possible. Patients can go on airplanes, and we provide local contact information for LVAD hospitals should a visit be necessary.
  • Patients are able to drive once fully healed about 3 months after surgery.
  • Patients cannot go swimming.
  • Showering is possible about 6 weeks after surgery with the use of protective equipment to prevent the controller and batteries from getting wet.
  • LVADs are not for everyone, and there are some forms of heart failure that cannot be treated with this therapy.
  • Some patients with other illnesses such as COPD may not be candidates for LVAD therapy due to the risk of surgery.
  • LVADs do not improve other illnesses such as diabetes and COPD. If patients have problems, these may persist after LVAD surgery and limit how well they do.
  • Tufts Medical Center has more experience than any other hospital in New England with this therapy.

LVAD complications

  • The LVAD is not a full support device, but provides assistance to the heart. Some patients may have persistent heart failure symptoms after LVAD surgery due to the right side of their heart not working well.
  • Some patients continue to have symptoms, such as weakness, after the LVAD surgery. Heart failure affects the entire body, including your muscles. Patients typically require physical therapy after surgery, and it can take up to 6 months until strength and conditioning is fully restored.
  • LVAD patients may die of worsening heart failure or from other complications such as infection, stroke or blood clot.
  • Many patients are rehospitalized due to complications that could be small or large. Some patients require multiple hospital stays due to these various complications.
  • About 1 in 10 patients may have a stroke.
  • About 1 in 5 patients may develop bleeding from their stomach or their bowel and may need a procedure such as a colonoscopy.
  • About 1 in 5 patients develop an infection and need antibiotics.
  • Patients can develop a blood clot in their LVAD and require replacement of their LVAD with another surgery.

Patient and caregiver commitment

  • Receiving an LVAD requires a big commitment from the patient and family as well as from the medical team.
  • Patients are required to have full time support at home with a caregiver who is knowledgeable about caring for the device in emergencies.
  • Patients need to work closely with the medical team and work hard to take care of themselves to do well on their LVAD.
  • Emergencies are uncommon and patients can call the LVAD team 24 hours a day.
  • Early on, patients are seen every week in the clinic for 2–4 weeks, then every other week and eventually every 1–2 months.
  • The devices are easy to operate. Patients need to know how to change power sources and respond to alarms, and are taught how to do a controller change in case of an emergency.
  • The technology is reliable, and it is rare for a patient to die because of a malfunction while at home.
  • Patients need to discuss difficult questions with their families as to what care they would want should they have a serious complication (such as a stroke) or become unable to make their
    own decisions.