Left Ventricular Assist Device (LVAD) — Procedure Guide, Recovery & Risks | MyMedicPlus

An LVAD is a surgically implanted mechanical pump that assists the failing left ventricle, maintaining blood flow in end-stage heart failure either as a bridge to transplant or as permanent destination therapy.

Indicated for NYHA Class III–IV heart failure unresponsive to maximal medical therapy, LVEF below 25%, VO2 max below 14 mL/kg/min, and either transplant ineligibility or confirmed transplant candidacy.

Under general anaesthesia with cardiopulmonary bypass, the pump inflow cannula is attached to the left ventricular apex and the outflow graft to the ascending aorta. HeartMate 3 operates at 5,400–6,000 RPM.

ICU stay averages 1–2 weeks; total hospitalisation is 2–4 weeks. Patients learn driveline exit site care before discharge. Cardiac rehabilitation follows, with activity restrictions lifting progressively over 6–12 weeks.

Major risks include stroke (10–15% annually), driveline infection (20–30%), right heart failure post-implant (25%), device thrombosis, and gastrointestinal bleeding due to ongoing anticoagulation therapy.

The HeartMate 3 MOMENTUM 3 trial showed 79% survival at 2 years with low stroke rates. Quality of life improves significantly; 6-minute walk distance increases by 100–150 metres within 6 months of implant.