What is an LVAD / What is a Support Heart

A Support Heart is the Dutch name for LVAD, the abbreviation for Left Ventricular Assist Device. Literally translated, this is “Left Ventricle Support Device”.

It is quite possible to have a fairly normal life in your own home environment with the LVAD.

How does an LVAD work?

An LVAD is a pump that is implanted when the heart is no longer strong enough to pump the blood, end-stage heart failure.
In the animation on the right, a clear explanation is given about the function of the heart and what happens in heart failure.

The LVAD itself is a small pump that is placed in the heart and forms a connection between the left ventricle and the aorta. This pump ensures that the body gets the correct flow of blood again.

Normally, the heart provides circulation with the help of a pulsating movement. You can feel the 'beating' of the heart in the arteries of the body. Because the pump provides a continuous flow, a wearer of an LVAD no longer has a palpable pulse.

The whole works on electricity. Electricity is controlled outside the body. The pump (1) is connected to an electrical cable, the driveline (3), which comes out through the abdominal wall, and is connected to the controller (4).
This controller is a small computer that controls the speed of the pump and emits a sound and light signal when necessary. The controller also provides the connection to the energy source, two batteries (2) that can be carried on the body, or a device that is connected to the mains. Thanks to the batteries, it is possible to resume daily life and be fully mobile. The device that is connected to the mains is used at night so that you can sleep with a constant supply of power.

What types of LVAD are implanted in the Netherlands?

There are two companies in the Netherlands that supply the LVAD. These firms have been taken over by larger medical companies over the years.

HVAD

The HeartWare company has developed this LVAD, hence the name HVAD (HeartWare Ventrical Assist Device). The HeartWare company has been taken over by Medtronic. The HeartMate 3 is a similar version of this HVAD, a pump placed in the left ventricle in the pericardium. This support heart will be implanted in the Netherlands from 2010. Look on the right for an animation video and here for more information on the HVAD.

HeartMate

Thoratec has been taken over by St. Jude Medical, which in turn has been taken over by Abbott laboratories.

Two types of LVAD have been developed here, the Heartmate II and the Heartmate 3

HeartMate II

The Heartmate II belongs to the first generation of continuous flow support hearts implanted from 2006 onwards. Until 2016, this is the most placed LVAD with the most experience until then. This pump was placed under the diaphragm in the abdominal cavity.
Look at the animation video on the right and have a look here for the difference between the HeartMate II and the HeartMate 3.

HeartMate 3

The HeartMate 3 was taken into use as a successor at the end of 2015 and was an improvement in many areas. Look here for the differences between these two models.

You can also see an animation of this on the right.

Which hospitals in the Netherlands implant the LVAD?

This operation takes place in the transplant centers that we know in the Netherlands, being it UMC-Utrecht,  it Erasmus MC in Rotterdam and the University Medical Center Groningen.

It LUMC There is no transplant center in Leiden and from 2010 to 2015, as an experiment, treated people who were not eligible for a transplant with an LVAD, ie as Destination Therapy. The costs involved were paid by the hospital. In 2015, the support heart was included as a treatment in the basic insurance package. Now it is possible in any hospital to get the LVAD as a treatment on its own.