WHAT IS AN LVAS?
The Terumo DuraHeart belongs to a class of devices called Left Ventricular Assist Systems (LVAS). These devices have been developed to help treat congestive heart failure (CHF). An LVAS assists the left side of the heart in pumping blood throughout the body.
WHAT IS THE DURAHEART?
The DuraHeart LVAS is made up of several parts. The main component of the DuraHeart LVAS is the DuraHeart pump. There are several additional parts that support the pump:
- Inflow conduit connects the pump to the heart
- Outflow conduit connects the pump to the aorta
- Controller acts as the “brains” of the pump
- Pump cable connects the pump to the controller
- Rechargeable batteries supply power to the pump
- Battery charger can power the pump and recharge the batteries
- Hospital Console is used to communicate and adjust the pump’s performance
WHAT IS THE DURAHEART PUMP?
The central component of the DuraHeart LVAS is a small pump that is implanted into the upper abdomen. The pump removes blood from the heart and propels it through the aorta to the body. The pump has a pump cable that exits the skin and connects to the controller.
WHAT IS THE DURAHEART CONTROLLER?
The DuraHeart controller is a small device carried or worn outside the body. The controller connects to the pump cable and is powered by batteries. The controller is the “brains” of the DuraHeart LVAS. Some of its functions include:
- Regulating power to the pump from the batteries or battery charger
- Monitoring the pump and displaying information on a small screen (such as how much blood is flowing through the pump)
- Alerting patients with lights, sounds and messages when the batteries are getting low or if the system requires attention
WHAT ARE THE DURAHEART BATTERIES AND CHARGER?
The DuraHeart pump always uses two power sources; either two batteries or one battery and the battery charger. In addition to providing power to the pump, the charger can recharge up to three (3) batteries at a time.
WHAT IS THE HOSPITAL CONSOLE?
The Hospital Console is used to communicate and adjust the pump’s performance.
WHO NEEDS A DURAHEART LVAS?
The DuraHeart LVAS is meant for people with failing hearts who are currently unable to receive a heart transplant due to donor availability or other factors.
WHAT ARE THE BENEFITS OF A DURAHEART LVAS?
The DuraHeart LVAS is designed to give heart failure patients more time to be with family and friends, continue work, and do the things they enjoy. Many patients can be discharged from the hospital and return to an active lifestyle with an LVAS.
WHAT ARE THE RISKS?
LVAS implantation requires open heart surgery and carries similar risks. These risks include stroke, bleeding, infection and blood clots. The doctor will explain additional risks based on the patient’s specific medical condition.
HOW DOES A NORMAL HEART WORK?
In a healthy heart, the left ventricle is the primary pumping chamber. The left side of the heart delivers oxygen-rich blood to all parts of the body. Used blood returns to the right side of the heart and is sent to the lungs to be “refueled” with oxygen.
HOW DOES THE HEART WORK WITH A DURAHEART LVAS?
The DuraHeart LVAS helps the left ventricle pump oxygenated blood throughout the body. Since a failing heart cannot pump enough blood to the body, the DuraHeart takes over the additional work. With an implanted DuraHeart LVAS, blood flows from the left ventricle along two paths. Blood flows along its normal route, from the left ventricle directly to the body. At the same time, the DuraHeart pump assists the heart by pushing blood from the bottom of the left ventricle to the aorta.
WHO IMPLANTS AN LVAS?
Heart surgeons with specially trained teams perform LVAS implantations.
HOW DOES THE DURAHEART LVAS FIT IN THE BODY?
Because of its small size, the DuraHeart pump can be implanted comfortably into a pocket created in the abdomen. The exact fit depends on the patient’s size. The pump cable exits the body on the right side. A special carrying bag is available to help support the controller and batteries during daily activities.
CAN YOU GO HOME WITH AN IMPLANTED DURAHEART LVAS?
The DuraHeart LVAS was designed for use inside and outside the hospital. The amount of time spent in the hospital depends on many factors. However, it is not unusual for patients with an implanted LVAS to return home within a few weeks after surgery.
WHO IS INVOLVED IN PATIENT CARE AFTER IMPLANTATION?
Within the hospital there is a specially trained LVAS team who will prepare the patient for surgery, implant the device and provide care following implantation. The team will also help patients and their families learn more about caring for and living with the DuraHeart LVAS. This team may consist of surgeons, cardiologists, nurses, psychologists, social workers and other healthcare professionals.
WHAT TYPE OF CARE IS NEEDED AFTER SURGERY?
In most cases the patient will spend time in the intensive care ward following surgery before moving to a standard hospital ward. After regaining strength and recovering, most centers will release the patient to the care of his or her family. Before release, the patient and other support people will need training on the use and care of the DuraHeart system.
IS MEDICATION REQUIRED?
Medication may or may not be needed based on the patient’s medical history and condition following surgery. The doctor will determine what medication may be needed in conjunction with a DuraHeart LVAS.
IS A SPECIAL DIET REQUIRED?
No special diet is required with the DuraHeart LVAS. However, because one of the goals is for the patient to become stronger, the doctor will likely recommend eating a healthy, sensible diet.
HOW DO A PATIENT’S ACTIVITIES CHANGE?
After receiving a DuraHeart LVAS, the patient may not swim, take a bath, or do heavy work. The patient must be careful not to pull the cable that exits through the skin; however, he or she will be able to perform most normal daily activities like cycling and shopping. The patient will be able to move about freely for up to five hours using two fully-charged batteries; this time can be extended simply by carrying additional batteries while out of the house.
DOES ELECTRICAL EQUIPMENT AFFECT THE DURAHEART LVAS?
The response of the DuraHeart LVAS to many common sources of electrical interference has been thoroughly tested. However, it cannot be ensured that all sources of electrical interference in today’s complex environment will not affect the system.
HOW IS THE CABLE EXIT SITE CARED FOR?
As long as the patient has a DuraHeart LVAS, a cable will exit through the skin and connect the controller to the pump. To avoid infection, the exit site must be kept clean and protected. The doctor or hospital will provide additional care instructions for the patient to follow as recovery progresses.
WHAT MAINTENANCE IS REQUIRED FOR THE DURAHEART LVAS?
The DuraHeart system is built to be durable and simple to use. Besides recharging and changing batteries and daily checks on the charger, the system does not require regular maintenance by the user.
HOW OFTEN MUST A PATIENT VISIT THE DOCTOR?
Patients with an LVAS need to be followed regularly by their doctor. Immediately following implantation, patients are checked often. However, as the healing continues, visits to the doctor may decrease to as little as once per month or less.