Understanding Advanced Heart Failure and Ventricular Assist Devices

Heart failure is a chronic health problem. It’s a gradual weakening of the heart. It’s when your heart can no longer pump the amount of blood your body needs to work properly. Heart failure can affect the right, left, or both ventricles of your heart.

If the right ventricle of your heart is failing, your heart may have trouble filling up with enough blood. If the left ventricle is weak, your heart may not empty completely when it pushes blood out to the rest of your body. In either case, a ventricular assist device (VAD) can support one or both of your ventricles. It can help your heart pump blood throughout your body.

What is advanced heart failure?

Heart failure happens over time. In its early stages, your heart may be weaker. But it may not be weak enough to cause any symptoms. As the condition worsens, or advances, though, you may start to suffer from tiredness (fatigue) and shortness of breath. These symptoms may occur only while exercising or doing activities such as climbing stairs.

Lifestyle changes and medicine can often help ease the symptoms of heart failure. You may feel better for a time. But your heart will continue to weaken. Eventually you may develop advanced heart failure. That’s when you have symptoms even at rest. Treatments such as medicine may also no longer work.

What are the symptoms of advanced heart failure?

In advanced heart failure, daily activities like dressing may become hard to do. You may feel extreme fatigue. You may also have swelling in your legs, ankles, feet, and belly (abdomen). Swelling happens because fluid builds up in your body.

Other symptoms of advanced heart failure include:

• Trouble breathing while sleeping

• Chest congestion

• Weight gain from fluid buildup

• Weight loss from a lack of appetite

• Chest pain

• Lightheadedness

• Heart palpitations or flutters

• Abnormal heart rhythms (arrhythmias)

• Depression

How can a VAD help with advanced heart failure?

Advanced heart failure can be cured only with a heart transplant. But you may have to wait some time for a donor heart. Or you may not be able to have a heart transplant because of your age or other health problems, such as kidney disease. In these cases, a VAD can help you feel better and be more active. It may extend your life.

A VAD can ease your symptoms while you are waiting for a transplant. This is called a bridge to transplantation. If you can’t have a transplant, you may use a VAD as long-term treatment for your heart failure. This is called destination therapy.

Is a VAD right for you?

Before you can have a VAD implanted, your healthcare provider will talk with you about the benefits and risks. He or she will have to determine whether a VAD is right for you. You will need some tests to check on your heart and overall health. You also need to be healthy enough to have the surgery.

Living with a VAD can be challenging. It requires a lot of follow-up care. You will need periodic checkups and tests. You will also have to make some lifestyle changes. A care team will help you make the transition to living with a VAD.