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LVAD Surgery Saves Man With End-Stage Heart Failure: All You Need To Know

The patient who received the LVAD Surgery with the doctor. A left ventricular assist device (LVAD) is used for patients who have reached end-stage heart failure and are ineligible for heart transplantation.

Heart failure means the heart is no longer able to pump blood to meet the body's needs. End-stage heart failure is the final and most severe stage of the condition that causes severe shortness of breath, swelling, and fatigue, among other symptoms. As such patients at this stage are at high risk of dying within a few months, it requires emergency treatment, which could be surgery, heart transplant, or ventricular assist devices. Recently, doctors at a private hospital in Faridabad successfully conducted an LVAD surgery to save the life of a 58-year-old man with end-stage heart failure. It is believed to be the very first LVAD surgery conducted in the state of Haryana.

LVAD is a battery-operated, mechanical pump surgically implanted in the patient's heart. The device is designed to augment the pumping function of a weakened heart and serves as a bridge to heart transplantation for those who are ineligible for heart transplantation.

The surgery was performed by a team of doctors at Marengo Asia Hospitals Faridabad, led by Dr Kumud Dhital, Director of Cardiothoracic and Vascular Surgery, Heart Lung Transplantation, and Mechanical Circulatory Support programs.

The surgery was planned and conducted on the 28th of June and the patient underwent uneventful implantation of the Heartmate III Left Ventricular Assist Device (LVAD).

When LVAD surgery is usually recommended?

The patient, Siraj (name changed) was presented with signs of advanced ischemic cardiomyopathy secondary to coronary artery disease. He had undergone percutaneous cardiological intervention with stenting of the main heart artery earlier. Despite the best medical therapy that he received, his heart condition worsened and left him with options between a heart transplant or durable mechanical circulatory support. The option of a heart transplant presented several challenges, in addition to his being an international patient, such as a prolonged waiting period on the transplant list. This would have worsened the functioning of the other organs, kidney function, and high pressure on his lung arteries. This would have terminated his chances as a candidate for a heart transplant as well.

Explaining how the device works, Dr Kumud said, "The 3rd generation magnetically levitated, continuous flow Heartmate III LVAD is now the gold standard device for both bridge-to-transplantation and life-long destination therapy. The device includes a pump that is sewn into the heart so it can draw blood from the dysfunctional left ventricle, the main pumping chamber, and pumps blood directly into the aorta. An electrical driveline exits the abdominal wall which is then connected to a portable controller and battery pack."

The patient has made an excellent recovery and is managing 20 minutes on the treadmill which is a significant amount of exercise. He was discharged on 12th July to the community. He has been advised of rigorous follow-ups to ensure that he and his family are confident in managing the functioning and care of the device before travelling back to his country.

First LAVD surgery in Haryana!

Dr Raajiv Singhal, Managing Director and Group CEO, Marengo Asia Hospitals, claims that it is the very first LAVD surgery conducted at Marengo Asia Hospitals, and in the state of Haryana.

"LVAD is a revolutionary device representing a significant leap and a paradigm shift in cardiac treatment and care for patients, offering new hope and quality of life," he added.

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Differences Identified According To Ejection Fraction In Heart Failure

Patients with acute decompensated heart failure (ADHF) have significant differences according to left ventricular ejection fraction, according to a study recently published in BMC Cardiovascular Disorders.

Ming-Shyan Lin, from Chang Gung Memorial Hospital Chiayi Branch in Taiwan, and colleagues conducted a retrospective cohort study between 2001 and 2021 involving ADHF patients discharged from hospitals. The primary outcome components were cardiovascular mortality and heart failure rehospitalizations, as well as all-cause mortality, acute myocardial infarction (AMI), and stroke.

A total of 12,852 ADHF patients were identified, including 17.3 percent with heart failure with mildly reduced ejection fraction (HFmrEF). The researchers found that patients with HFmrEF had a significant phenotype comorbid with diabetes, dyslipidemia, and ischemic heart disease in comparison with patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).

Similar rates of cardioversion and coronary interventions were seen for both HFmrEF and HFrEF. An intermediate clinical outcome was seen between HFpEF and HFrEF; the highest rate of AMI was seen with HFmrEF (9.3, 13.6, and 9.9 percent for HFpEF, HFmrEF, and HFrEF, respectively). The AMI rates were significantly higher in HFmrEF than HFpEF but not HFrEF.

"These findings are of importance to future research strategies on prevention and treatment of different HF types and ischemic heart disease," the authors write.

More information: Ming-Shyan Lin et al, Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study, BMC Cardiovascular Disorders (2023). DOI: 10.1186/s12872-023-03286-9

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Citation: Differences identified according to ejection fraction in heart failure (2023, July 20) retrieved 27 July 2023 from https://medicalxpress.Com/news/2023-07-differences-ejection-fraction-heart-failure.Html

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Man's Heart One Of Few To Improve With Left Ventricular Assist Device

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