Do You Have Heart Failure? Study Finds Surprising Benefits of LVADs
With the right patient who understands the risks and benefits, the device can provide more options for treatment
A special device that helps the heart pump blood may benefit more patients with heart failure than previously thought, a recent study says.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
The device, called a left ventricular assist device (LVAD), is placed inside the heart. The device helps the weakened left ventricle — the major pumping chamber of the heart — to pump oxygen-rich blood throughout your body.
If you have end-stage heart failure, the LVAD can:
Many patients who receive LVAD devices are in the hospital and depend on intravenous medicines that help their hearts pump blood. This study looked at patients who don’t require intravenous medication and compared those that received the LVAD with those who elected to continue with oral medications.
In the study, researchers analyzed the clinical outcomes of 200 patients with advanced heart failure at 41 U.S. health centers. One group received LVADs and one group continued with oral medical treatments only.
The death rates for patients in both groups were similar, says Randall C. Starling, MD, MPH, a Cleveland Clinic heart failure cardiologist on the research team. However, those with LVADs experienced better event-free survival, functional capacity, and quality of life than those receiving medical treatment only.
“The key finding there was that patients who received LVADs had better quality of life, had less depression, and could walk further in six minutes,” Dr. Starling says.
Also, about 18 percent of those who did not receive the LVADs at first ended up needing them within a year after the study began.
While LVAD surgery has a low risk of death and gives patients improved functional capacity, it does come with some risk for side effects, Dr. Starling says. The group of patients in the study with LVADs experienced a greater frequency of adverse health events although they were not typically fatal or disabling.
Most of the side effects of LVADs are a result of the limits of current technology related to the device, he says. Most patients with current LVADs do not have a pulse and this may predispose them to many of the complications. Newer LVADs are designed to produce pulsing blood flow like a normal human heart.
While some patients in the study with LVADs experienced side effects such as bleeding, the patients who did not receive the device had to return to the hospital more often for reoccurring heart failure.
The study shows researchers that with the right patient — who understands the risks and benefits associated with a LVAD — the device can provide more options for treatment, Dr. Starling says. This is especially true for people for whom there are few treatment options remaining, he says.
“Those who undergo LVAD surgery will have better quality of life and better functional capacity, even to the point where some people might even think about returning to work — depending on what their line of work is — who couldn’t even dream of doing that on continued medical therapy,” Dr. Starling says.
More research is necessary to define the benefits and risks of LVADs in patients with less severe heart failure, Dr. Starling says.
Patients with advanced heart failure who are admitted to the hospital several times in a year should consider a referral to a center that has experience with LVAD implantation, Dr. Starling says.