Learn more about mechanical circulatory support devices used to treat advanced and end-stage heart failure.
For patients with advanced or end-stage heart failure, heart pumps known as mechanical circulatory support (MCS) devices can help restore blood flow, increase survival and improve quality of life. For long-term support, the two most commonly used types of MCS devices are left ventricular assist devices (LVADs) and the Total Artificial Heart (TAH). These devices can be used in several different ways.
Bridge to Transplant
An MCS device can be used to improve survival and quality of life in patients waiting for a donor heart to become available for transplant. This use is known as bridge to transplant (BTT).
In patients who are not eligible to receive a heart transplant because of age or other medical conditions, an MCS device can be implanted as a permanent option to extend survival and improve quality of life. This use is known as destination therapy (DT).
Bridge to Recovery
Occasionally, patients implanted with an LVAD may experience recovery of their heart function and be able to have the device removed. This is known as bridge to recovery (BTR).
Let’s explore LVADs and the TAH further in order to better understand when and how they are used and how they can help.
What is an LVAD?
An LVAD is an implantable, mechanical pump that attaches directly to the patient’s heart. It is designed to assist, or in severe cases, take over, the pumping function of the left ventricle. The device is implanted in the abdomen, just below the diaphragm, and pumps blood from the left ventricle (the main pumping chamber of the heart) to the aorta (the main artery that carries oxygenated blood to the body). An external, wearable system that includes a controller and two batteries is attached by an external wire called a driveline. A majority of LVAD patients are discharged from the hospital after they recover from the surgery and are able to resume their normal activities and hobbies at home.
LVADs can serve as a bridge to transplant, destination therapy or bridge to recovery, depending on the type of LVAD used and the circumstances and/or needs of the patient receiving it.
What is the Total Artificial Heart?
The TAH is an implantable device that replaces both the right and left ventricles, as well as the four heart valves, and occupies the space of the removed, failing human heart. The TAH is used in patients with end-stage heart failure affecting both sides of the heart (biventricular failure).
Currently, the only commercially approved TAH is the SynCardia temporary Total Artificial Heart. Manufactured in two sizes — 70cc and 50cc — the SynCardia TAH is powered by air, which is supplied by an external machine called a driver.
Learn more about how the TAH works here.
Currently approved for use as a bridge to transplant, the 70cc SynCardia TAH is also undergoing an FDA clinical trial for use as destination therapy.
Stable TAH patients who meet discharge criteria are able to leave the hospital and lead active lives at home with their loved ones using the Freedom® Portable Driver. A few examples of activities TAH patients have been able to enjoy include hiking, cycling, fishing, dancing, returning to work and more.
Check out our patient stories here.
Which MCS Device is Right for Me?
Based on your condition, size, needs and other variables, your medical team will first determine if you are a candidate for MCS, then recommend which device is best for you. However, because heart failure is progressive and unpredictable, it would be beneficial for you to ask your doctor about all possible cardiac devices you could require as your condition progresses, and how many of those devices are actively being used at your hospital. As a patient, you want to make sure that your hospital has every tool available should you need it.