James Fang discusses LVADs for End-Stage Heart Failure with WebMD

More than 5 million Americans have heart failure, a progressive and often lethal condition that weakens the heart and saps its pumping power. The mainstays of treatment — including drug therapy, lifestyle modification, and surgery to implant pacemakers or defibrillators — can be quite effective at managing symptoms of mild to moderate heart failure.

But what about the estimated 150,000 Americans who suffer from chronic, severe heart failure?

Doctors traditionally have had little to offer these patients in the way of lifesaving treatment, short of a heart transplant. But with only about 2,100 donor hearts available each year, the demand for hearts inevitably outweighs the supply. And some patients are simply too old to qualify for a transplant. For them, what’s the alternative?

There’s now an option that could change the outlook for many with severe heart failure: implantable mechanical pumps called left ventricular-assist devices (LVADs or sometimes simply VADs.)

These devices were once just used as a “bridge” — a temporary stopgap to keep heart failure patients alive until they could get a heart transplant. But now, they have become so effective that doctors use them as a treatment in themselves. LVADs are now an alternative to heart transplants, permanently augmenting the action of a heart’s main pumping chamber.

In addition, the continuous-flow LVAD was associated with fewer infections and a significantly lower rate of failure.

“The continuous-flow LVAD has changed the landscape of advanced heart failure,” says James C. Fang, MD, chief medical officer of the Harrington-McLaughlin Heart and Vascular Institute at University Hospitals Case Medical Center in Cleveland and the author of an editorial on LVADs that accompanied the study in the New England Journal of Medicine.

“In addition to being more durable, the new device is a lot smaller – about the size of a D battery. It’s also quiet. You can barely hear it. With the old devices, you could hear them coming down the street.”

Find the full article on CWRUmedicine.org

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