Heart Failure Forward!

Almost 1 million Americans are hospitalized each year for heart failure and related problems, and more than half a million are newly diagnosed annually. ChristianaCare is the only health system in the state of Delaware to offer LVAD (left ventricular assist device) implementation for our patients across the region. LVAD is the most advanced treatment short of heart transplant for people with heart failure. To understand how LVAD helps heart failure patients, let’s understand heart failure and how it relates to patients being able to receive LVAD implants.

Heart failure means your heart muscle doesn't pump enough blood to meet your body's needs. This doesn't mean your heart has stopped but isn't pumping as well as it should. Because your heart cannot pump well, your body tries to compensate for it. To do this:

• Your body holds on to salt and water, increasing the blood in your bloodstream.
• Your heart beats faster.
• Your heart might get bigger.

In the early stages of heart failure, you may:

• Feel tired easily.
• Be short of breath when you exert yourself.
• Feel like your heart is pounding or racing (palpitations).
• Feel weak or dizzy.

As heart failure worsens, fluid builds up in your lungs and other parts of your body. This may cause you to:

• Feel short of breath even at rest.
• Have swelling (edema), especially in your legs, ankles and feet.
• Gain weight. This may happen slowly or even over a day or two.
• Cough or wheeze, especially when you lie down.
• Feel bloated or sick to your stomach.

Heart failure is treated with medicines, a healthy lifestyle and the steps you take to check your symptoms. Treatment can slow the disease, help you feel better and keep you out of the hospital. It may also help you live longer. Treatment options include:

• Several medicines.
• Living a heart-healthy lifestyle that includes limiting sodium, getting regular exercise, not smoking and eating healthy foods.
• Watch for changes in your symptoms.
• Cardiac rehabilitation (rehab) can give you education and support that help you stay as healthy as possible.
• You may get a heart device like a pacemaker or implantable cardioverter-defibrillator (ICD).

As heart failure gets worse, you may have other options, such as an LVAD (left ventricular assist device) or a heart transplant.

An LVAD is a surgically implanted mechanical pump that helps improve blood flow from your heart to the rest of your body. It's used when your heart cannot pump enough blood on its own. LVAD is one of the few long-term options available for those who can’t get a transplant. Your provider may recommend that you get an LVAD if:

• You are waiting for a heart transplant.
• Your heart needs long-term help to pump blood.
• Your heart is healing from an injury or illness and needs help until it can pump on its own.

The device pulls blood from the heart and pumps it into the aorta. The aorta sends blood to the rest of the body. Most of the blood your heart normally pumps is pumped by the device instead.

A left ventricular assist device (LVAD) can be used as a temporary or long-term treatment for severe heart failure. LVAD may be used for only a short time if a person's heart strengthens again and can pump blood well enough. LVADs may be used to help people who are waiting for a heart transplant. In some cases, LVADs can be used long-term along with other heart failure treatments like medicines.

Using an LVAD before a heart transplant can help patients live until they receive the transplant. Long-term LVAD therapy may reduce the risk of death compared to medical treatment alone and improve daily activity levels.

ChristianaCare has used the HeartMate 3 LVAD, the most recent and advanced option, for over six years. With previous LVADs, patients had higher risks of clots, leading to hospitalization and surgery to exchange the pump. That risk is significantly reduced in the HeartMate 3 because the device’s rotor is magnetically levitated or suspended, providing ample space for the blood. Additionally, the newest pump contains a feature that “washes” the motor housing to reduce the risk of clots developing further. Stroke risk is also reduced. As with any procedure, your provider will discuss the benefits and risks for you. Talk with your provider about any questions or concerns you may have.

Most people feel better and have a better quality of life. They can be active, drive, work, socialize and enjoy hobbies. If you have an LVAD, our heart failure program team will provide regular follow-up visits and teach you how to care for your LVAD at home. They will teach you how to care for your LVAD at home and how to prevent problems. Self-care that you might do at home includes checking the device and changing the dressing. With the HeartMate 3, early survival is now approaching that of heart transplant and continues to evolve.

Connect with one of our heart and vascular providers to discuss heart failure treatment options by calling the Wilmington ChristianaCare Center for Heart & Vascular Health at 302-733-1663.