Heart failure is a complex condition and often requires a combination of treatments. At Harefield Hospital, severe heart failure patients can benefit from ventricular assisted device surgery using a minimally invasive approach.
It is estimated that over half a million people in the UK are living with heart failure. This is a long-term condition and occurs when the heart doesn’t pump blood as efficiently and effectively as it should.
Typical symptoms of heart failure can include excessive tiredness and shortness of breath, particularly when exercising or lying down. Heart failure can develop suddenly or over a period of time. Common causes of heart failure include heart attack, high blood pressure, and cardiomyopathy.
For many people, the condition requires ongoing treatment, but when there is a specific cause of heart failure – such as clogged arteries, damaged valves or heart rhythm abnormalities – surgery is usually the only option.
Harefield Hospital is one of the leaders in ventricular assist device (VAD) technology and implantation. The implantable device acts as an artificial heart pump and is used to treat people with severe heart failure. It helps the failing heart and aims to restore normal blood flow.
The implanted device acts as a pump to circulate blood from the main chamber of the heart around the body. VADs are designed to assist either the right ventricle (RVAD) or the left ventricle (LVAD), and in some instances to assist both ventricles (BiVAD).
Other surgical interventions for heart failure include the implantation of a subcutaneous defibrillator (to give small electrical shocks to help control arrhythmias) and/or a cardiac permanent pacemaker (to keep the heartbeat regular).
Minimally invasive device implantation
Surgical intervention can save a patient's life by allowing the heart to function correctly. A healthy heart can reduce the risk of stroke and thrombosis.
The VAD programme at Harefield Hospital is one of the world’s most established. The experts at Harefield Hospital have been performing the procedure for over 20 years, and it has one of the highest success rates in the UK. The expert team implant the largest number of devices in the UK and many overseas teams visit the hospital for training.
Harefield Hospital is the only centre in the UK to implant the VAD using minimally invasive surgery. This approach uses two small incisions (sternum-sparing), rather than a traditional open-heart method, which allows for lower rates of infection and faster recovery times. Additionally, this approach also has enormous benefits for any additional surgeries.
In the last decade, a significant number of people have received this device instead of a heart transplant. This works well for patients unsuitable for heart transplants, especially if they have underlying health problems or weight issues. The development of VADs have allowed permanent implantation and can significantly increase the patient’s quality and length of life.
Testing, diagnostics and aftercare
Assessment for a ventricular assist device (VAD) involves an extensive prescreening and is performed before the VAD implantation is recommended. This includes blood tests, echocardiogram, chest x-rays, angiogram (cardiac catheterisation), ECG, renal function, lung function as well as psychological testing. This process identifies if the patient is suitable for the device and will benefit from implantation of the device.
Once the VAD is implanted, patient aftercare is paramount for long-term results. This includes follow-ups with trained nursing staff, cardiac rehabilitation and a 24-hour on-call service.
Mr André Simon explains: “Harefield Hospital is a specialist cardiothoracic centre with experience of treating extremely complex cases. The hospital’s specialist teams have an enormous amount of experience and expertise in ventricular assist device (VAD) implantation and aftercare compared to other hospitals.”
At a glance
Insertion of a left ventricular assist device (LVAD)
Carried out by
Mr André Simon
Consultant cardiothoracic surgeon; Director of heart and lung transplantation and mechanical circulatory support
Professor Ulrich Stock
Consultant cardiothoracic surgeon
How does it work?
To insert an LVAD, the surgeon attaches one end of the pump to the left ventricle and the other end to the aorta. The device takes blood from the aorta and helps pump it to the body, just as a healthy heart would.
The driveline connects the LVAD, which is inside the body, through the skin to a controller outside the body. Sensing the LVAD’s function, it controls the power to make it work. The controller connects to an external battery pack that patients must carry at all times.