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LVAD Surgery
- Days In Hospital 15 days
- Outside Hospital Stay 45 days
- Success Rate 75%
Minimum Cost
$ 70000
Maximum Cost.
$ 100000
Overview of LVAD Surgery in India
A left ventricular assist device (LVAD) is a pump that is surgically implanted in patients by their healthcare providers and or cardiologist, and it is designed to help patients who have heart failure. A LVAD assists the left side lower chamber of your heart (left ventricle) with pumping blood out of the left ventricle into your aorta and around your body. Since the device provides assistance specifically to the left ventricle, it is a left ventricular assist device.
The role of the LVAD is significant because your aorta is responsible for supplying the entire body with oxygenated blood. Just like your heart and blood vessels could not maintain your life, the same can be said about oxygen; you will not be able to live without a steady supply of oxygen to all cells and tissues.
How Does A Left Ventricular Assist Device Work?
A left ventricular assist device operates by pumping blood from your left ventricle to your aorta. Your aorta is the main artery that carries blood from your heart to the rest of your body.
A surgeon puts the pump unit of the left ventricular assist device at the bottom of your heart inside your chest. Blood is received by the device and sent via tube to your aorta.
What Are The Parts Of A Left Ventricular Assist Device?
Components of a left ventricular assist device (LVAD) are as follows:
Pump. It is attached to a driveline (cord) and a control system (controller).
Driveline. Runs from the pump through the skin on your abdomen to the controller (small computer and display) on the outside of your body.
Controller. Runs the pump. Messages and alarms from the controller will aid in operating the system.
Power Source. Will keep the LVAD running with rechargeable batteries or a cord that plugs into the wall. Depending on the device, batteries can last up to 14 hours. When the battery is low, you will need to change it.
Types of LVAD Surgery:
According to the design and method of implantation, LVADs are divided into different types.
Centrifugal Flow LVADs
Centrifugal flow LVADs utilize a rotary force to aid the movement of blood from the left ventricle to the aorta and then to the body. This generally used LVAD is generally durable and offers the possibility for long survival.
Axial Flow LVADs
Axial flow LVADs also use a mechanism that generates a force to shift blood from the left ventricle to the aorta. Unlike centrifugal LVADs, this method of LVAD provides continuous blood flow.
Pulsatile Flow LVADs
Pulsatile flow LVADs are less commonly deployed LVADs. Pulsatile flow LVADs create the pulsatile flow of blood as a natural effect of the heart. Pulsatile flow LVADs use an internal mechanism that rhythmically pushes blood like the heart does.
Total Artificial Heart
In situations of end-stage heart failure, a total artificial heart is a possible implantable option. This device replaces both the left and right ventricular function and supplies an entirely permanent solution for blood flow support.
Implantable LVADs
These devices are surgically implanted internally in the body. They typically require a more invasive procedure, yet provide more support of the heart function.
Paracorporeal LVADs
These devices are partially implanted and connected to an external machine. They are frequently used before heart transplantation.
Procedure:
Before the Procedure
A person requires surgery to receive an LVAD. Before the procedure, a clinician will evaluate the heart failure severity, and account for other critical health problems, assess cardiac chamber function and ability, examine the ability to take blood thinners safely, and potential for family support. The clinician will use these factors to consider treatment with LVAD.
A person's physical health will be assessed with blood work, ECGs, chest x-ray, and echocardiogram. These procedures are conducted to evaluate the function of body systems, and to determine the current state of their health. An ECG will assess the electrical function of the heart, a chest X-ray will evaluate the shape and size of your heart, and an echocardiogram will determine the structure of the heart, the valves, and blood flow to and through the heart.
A long, thin catheter will be placed in the neck and guided under x-ray to monitor the pressures and blood flow through the heart. This information will help the clinician determine if LVAD will be an appropriate treatment choice.
During the Procedure
Anesthesia: Anesthesia is provided for the comfort of the patient and to manage pain or discomfort during the procedure.
Surgical incision: An incision is made in the chest to gain exposure to the heart.
Positioning of the LVAD: The LVAD is placed near the heart of the patient. The LVAD consists of a pump that assists the left ventricle (the main pumping chamber of the heart) with circulating blood. Options for connection of the pump to the heart or major blood vessels will be considered.
Connecting the parts: Tubing is also connected to the chambers of the heart and blood vessels that allow blood to be taken from the heart and into the LVAD pump, and then allowed back in to the body.
Power source: The LVAD is powered from an external source, which is worn outside of the body, and is essential for operation and blood circulation.
Closing the incision: A surgical incision is closed with use of sutures or staples once the LVAD is secure.
Recovery: The patient is carefully monitored during the recovery phase; very commonly in the intensive care unit (ICU). Adjustments to the LVAD may also be made during the recovery phase to optimize functioning.
After the Procedure
A patient will be under continuous observation until the vital signs stabilize and for any complications. Medications, including antibiotics, pain medications, and blood thinners will be administered to prevent infection and pain and to prevent blood clots, and the patient is likely to receive ventilator assistance for breathing for a few days. Instructions will be given for LVAD care, such as cleaning and bandaging the area, keeping batteries charged, ensuring the battery is not damaged, and observing the LVAD function. Recovery time depends on the patient's medical condition, for which follow-up appointments will be given to check if the device works and to look for any complications.
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Cost of LVAD Surgery in India
The cost of LVAD Implant in India ranges from 75000 USD to 105000 USD. The cost can vary according to the type of LVAD used in the procedure. It can also vary according to the condition of the patient at the time of surgery.
|
Cost of LVAD in Different Cities of India |
Min (USD) |
Max (USD) |
|
Delhi |
75000 |
95000 |
|
Chennai |
60000 |
80000 |
|
Mumbai |
75000 |
105000 |
|
Hyderabad |
65000 |
85000 |
|
Gurgaon |
70000 |
100000 |
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Indications of LVAD Surgery:
The following are conditions under which LVAD is implanted:
End-stage heart failure
Bridge to transplant
Destination therapy
Myocardial recovery support
Bridge to candidacy
Cardiogenic shock
Acute MI (heart attack) with devastating heart failure
Intractable angina (chest pain)
Cardiomyopathy with decompensated heart failure
Ventricular arrhythmias refractory to medical therapy
Risk Factors:
Infection
As with any other surgical procedure, there is a chance of infection at the time of LVAD implantation and at any other location in the body.
Bleeding and Hematoma
There is a risk of bleeding during and after the implantation process. It is possible that blood collects at the surgical site and can create very serious complications.
Pneumothorax
There is a small risk of pneumothorax and lung injury during the implantation process. Air leaks into the chest cavity and can create very serious complications.
Allergic Reaction
Some patients may develop an allergic reaction to materials used in a left ventricular assistive device.
Blood Vessel Damage
It is possible that blood vessels can be damaged when inserting the catheters. This can develop bleeding or create a hematoma.
Device Failure
At times, the LVAD may experience a mechanical malfunction which would require revision surgery for device replacement or repair.
Organ Failure
LVAD support can affect other organs, for instance, the kidney or liver, which can cause organ failure.
Right Heart Failure
LVAD support can worsen stressful conditions to the right heart which can lead to right heart failure, worsening the patient's symptoms.
Arrhythmias
The LVAD can cause arrhythmia which can cause severe or life-threatening conditions.