LVADs Explained: A Simple Guide to Advance Heart Failure Support

Hearing the words advanced heart failure can feel overwhelming. It’s a serious diagnosis and navigating the treatment options often feels like learning a new language. The good news is that modern heart failure care includes powerful options that can help people live longer, fuller lives when medications alone are no longer enough.

One of these life-changing technologies is the Left Ventricular Assist Device, commonly known as an LVAD. An LVAD doesn’t replace your heart. It supports your heart by helping it pump blood forward.

Understanding how an LVAD works can turn fear into clarity, and help patients and their families make confident, informed decisions.

What Is Heart Failure?

To understand an LVAD, we first need to understand the condition it treats. Heart failure is a frightening term that sounds like the heart has stopped beating entirely. In reality, it means the heart has become too weak or stiff to pump blood effectively to the rest of the body.

In the early stages, the heart compensates by enlarging or pumping faster. Over time, however, the muscle weakens further. Common symptoms include:

• Extreme fatigue, lightheadedness, fainting or low blood pressure
• Shortness of breath with minimal activity or even while resting
• Coughing, especially while lying down
• Swelling in the legs, ankles and feet
• Rapid weight gain from fluid buildup

When Is Advanced Heart Failure Treatment Needed?

For many people, heart failure is managed for years with a combination of lifestyle changes and medications like beta-blockers, Entresto, ACE inhibitors or ARBs. However, heart failure is a progressive condition.

There comes a point where medications are no longer sufficient to keep the blood flowing adequately. This stage is known as advanced heart failure and often shows up with worsening symptoms despite best medical therapy, difficulty doing normal daily activities and a frequent need for hospitalization. At this stage, doctors may discuss advanced therapies such as transplant evaluation and mechanical circulatory support such as an LVAD.

What Is an LVAD (Left Ventricular Assist Device)?

An LVAD is a battery-operated mechanical pump. It is surgically implanted inside the chest to help the left ventricle (the heart’s main pumping chamber) send oxygen-rich blood to the rest of the body.

It is important to distinguish an LVAD from a total artificial heart. An artificial heart replaces the diseased heart completely. An LVAD, however, attaches to your existing heart to support it.

Think of it like an electric bicycle: you are still pedaling (your heart is still beating), but the electric motor (the LVAD) provides the power needed.

How Does an LVAD Work?

The device has a few key parts that work together to help restore blood flow:

1. Pump: Implanted inside the chest, the pump draws blood from the left ventricle and pushes it into the aorta, the main artery that delivers blood to the body.
   
   
2. Driveline: A thin cable that connects the internal pump to the external system through the skin of the abdomen.
   
   
3. System controller: A small computer worn outside the body that monitors the pump and provides alerts if something needs attention.
   
   
4. Power sources: Portable batteries power the system during the day to allow for regular mobility. At night, many patients connect to a wall power unit for sleep.
   

Benefits and Risks of an LVAD

LVADs offer important advantages as well as some risks. Here’s what you need to know. 

Benefits

• Lifesaving support: Studies show people with advanced heart failure often live longer with an LVAD than with medications alone and can use it both as a bridge to transplant or as a long-term therapy for people who are not transplant candidates.
  
  
• Improved symptoms and improved quality of life are the goals. Most patients have more stamina and find it easier to breathe.
  
  
• Better organ function: Improved blood flow can help the kidneys and liver work better.

Risks

• Bleeding: Blood thinners are needed to reduce the risk of blood clots, but they also raise the risk of bleeding.
  
  
• Infection: The driveline exit site requires meticulous daily care.
  
  
• Stroke: Clots can form in the device or blood vessels.
  
  
• Right heart failure: The right side of the heart may struggle to keep up.
  
  
• Blood pressure management: Stable blood pressure is essential for LVAD function and your care team will work closely with you to manage this.

Who May Be Considered for LVAD Therapy?

Doctors generally consider LVAD surgery for patients with advanced heart failure who fall into three main categories:

• Bridge to transplant: For patients listed for a heart transplant, an LVAD can support circulation while waiting for a donor heart to become available.
  
  
• Destination therapy: For patients who are not transplant candidates, an LVAD can support their heart for the rest of their life.
  
  
• Bridge to recovery: In some situations, the LVAD allows the heart to fully or partially recover and the device is no longer needed. This is less common, but part of the evaluation discussion.

What Happens During LVAD Surgery?

LVAD implantation is open-heart surgery. It is a major procedure that requires a team of specialized cardiac surgeons, anesthesiologists and nurses.

• During the surgery, you are placed on a heart-lung bypass machine to support your breathing and circulation while the device is implanted.
  
  
• The surgeon attaches the pump to the bottom of the left ventricle and connects the outflow graft to the aorta.
  
  
• The driveline is then routed through the skin on the abdomen.
  

Recovery often includes an Intensive Care Unit (ICU) stay of several days, followed by a stay in a cardiac step-down unit. During the hospitalization, a specialized team teaches you and your caregivers how to manage the device safely before you go home.

Life With an LVAD

Living with an LVAD requires a new routine but for many patients, it marks a return to activities they thought were lost forever.

• Daily routines: You carry with you at all times your controller and batteries in a specially designed shoulder bag or vest.
  
  
• Hygiene and care: Keeping the exit site clean is critical.You will learn step-by-step dressing changes and infection prevention. Showering is often possible after healing using a specialized waterproof kit. Swimming and submerging the equipment in water (like a bathtub) are not allowed.
  
  
• Activity and lifestyle: Most patients report significantly more energy and improved day-to-day function. Your team will guide safe exercise, travel planning and return-to-work decisions based on your specific situation.

Frequently Asked Questions

• Is an LVAD permanent? It depends. For “destination therapy” patients, it is intended to be long term. For bridge-to-transplant it supports you until transplant. In rare cases, recovery may allow removal.
  
  
• Is an LVAD the same as a heart transplant? No. A transplant replaces the heart. An LVAD supports your existing heart.
  
  
• Can people travel with an LVAD? Yes. With planning, extra batteries and coordination with your LVAD team, many patients travel safely.

What To Do Next

If you or a loved one is facing advanced heart failure, ask your cardiologist if an advance heart failure consultation is appropriate. The goal is not just more time, but better quality of life with a plan you can understand and trust. For many, an LVAD is a lifeline that restores time with loved ones and the ability to enjoy daily life. While lifestyle changes are significant, the trade-off is often a renewed sense of vitality.

At the Stony Brook Heart Institute, LVAD care is delivered through a devoted multidisciplinary team dedicated to you with expertise in advanced heart failure and mechanical circulatory support.

• We are Long Island’s first and most experienced VAD program. We implanted our first LVAD in 2010.
  
• We have been continuously certified by The Joint Commission since 2011, reflecting sustained quality standards.
  
• Access to current-generation LVAD technology such as HeartMate III.
  
• Structured inpatient education for patients and caregivers, plus ongoing support designed to help you live well at home with the device.

For more information or an appointment, call (631) 444-3278 or visit our website.  

Three Stony Brook Medicine patients share brief reflections on life before and after receiving a Left Ventricular Assist Device (LVAD). In this short montage, each patient responds to the same set of questions, offering a snapshot of what led them to an LVAD and how it has impacted daily life. Together, their perspectives highlight common experiences, meaningful changes and moments of regained independence. The video offers a concise, patient‑centered look at living with an LVAD.