The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on short-term circulatory support with left ventricular assist devices as a bridge to cardiac transplantation or recovery.
Heart failure may be managed by a combination of medical therapy, intra-aortic balloon pumping and heart transplantation.
A temporary solution for patients who are waiting for a heart transplant is to insert an LVAD into the chest near the heart. The LVAD is a mechanical device that helps the heart to pump blood around the body. LVADs can be used to support the heart while it is recovering from a severe short-term heart failure syndrome (such as myocarditis). LVADs are sometimes also used while waiting for the heart to recover after cardiac surgery. This short-term mechanical support is sometimes described as bridging.
Several different LVADS are available and your surgeon will choose the one that is most suitable for you. The surgery to implant the device into the heart takes several hours and is done under general anaesthetic. The surgeon will cut through the chest wall. The LVAD has two pipes. One (the inflow) is inserted into the left side of the heart and the other (the outflow) is inserted into an artery, usually the aorta (the main artery from the heart to the body). The LVAD pumps oxygenated blood from the heart into the arteries.
K54.1 Open implantation of ventricular assist device
For removal of the ventricular assist device:
K54.2 Open removal of ventricular assist device