Doctor Healthy: Heart failure: Heart pumps help keep the beat

If you have heart failure, a heart pump may improve your quality of life.

When you have heart failure, your heart can't pump enough blood to meet your body's needs. Treatment is directed at the underlying cause, such as high blood pressure or coronary artery disease. Lifestyle changes and medication often help, too. If heart failure progresses, an advanced treatment such as a heart pump may be recommended.

A heart pump takes over the function of one or both of the heart's lower chambers, with the potential to improve your symptoms and quality of life. Once considered a last resort for prolonging life until a donated heart became available, heart pumps have become a possible long-term treatment for selected people with heart failure.

How does a heart pump work?

A heart pump replaces the work of one or both of the heart's lower chambers (ventricles). The pump — often about the size of a personal compact disc player — is implanted in your upper abdomen through open-heart surgery. Blood from the supported ventricle flows through the pump, into the aorta and then to the rest of your body. You'll feel the pump beat beneath your skin. The pump is connected to a battery pack worn outside your body, often in a small shoulder bag or fanny pack.

Some heart pumps are designed to support only the heart's left ventricle. These are known as left ventricular assist devices (LVADs). Other heart pumps support the right ventricle (RVAD) or both ventricles (biventricular assist devices).

A bridge to recovery

Sometimes a heart pump temporarily supports the heart as it heals from a massive heart attack, an episode of sudden heart failure or complications from open-heart surgery. In other cases, a heart pump works along with medication to improve heart function until transplantation is possible. With the help of a heart pump, your heart may even perform at normal or near-normal levels — alleviating symptoms and perhaps eliminating the need for a transplant. Occasionally it's possible to be weaned from the pump until it's no longer needed.

Or sometimes a destination

If your heart failure can't be appropriately managed with medication or special pacemakers and you're not a candidate for a heart transplant, a heart pump may offer promise as a long-term treatment. This is known as destination therapy — an option approved by the Food and Drug Administration in 2002.

When used along with medication, a heart pump doubles the one-year survival rate for people with end-stage heart failure. This remarkable benefit was first noted in a 2001 landmark study in which researchers confirmed the benefits of heart pumps compared with medication alone. A heart pump also improves the signs and symptoms of heart failure — such as breathlessness and fatigue — which can improve your quality of life.

Understand the risks

A heart pump can be a lifesaving treatment. Yet the potential risks are serious, including:

Infection
Blood clots
Stroke
Bleeding
Device malfunction

Some complications associated with a heart pump are life-threatening.

Living with a heart pump

Whether your heart pump is a bridge to transplant or your destination, you'll need to adjust to life with the pump.

Follow the instructions from your medical team. Specific precautions may vary depending on the specific type of pump.
Take your medication as prescribed. Your doctor may prescribe various heart failure medications, including anticoagulants to help prevent blood clots.
Anticipate the battery life of your pump. You may need to change the pump's batteries once or even twice a day. Store extra batteries in a cool place.
Keep it clean and dry. To prevent infection, carefully cleanse the area where the battery wire is implanted. Make sure your battery pack and the wire connecting the pack to the pump stay dry — even when you bathe.
Avoid magnetic resonance imaging (MRI) exams. These imaging studies use a strong magnet, which may interfere with the pump.
Watch for mechanical problems. You'll have regular check-ins with your doctor and device technician. Report any changes in the pump's sounds or motion immediately.
Be prepared for emergencies. Your doctor will provide a hand pump and emergency power pack in case the implanted pump fails. Make sure you and your caregivers know how to use the hand pump.

A heart pump can offer a second chance at life. Work with your doctor to make the most of it.

First aid

First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. It is also advised to be prepared for illness while traveling locally or to a foreign country. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.

Making Decisions About Cancer Treatment

fter a diagnosis of cancer, patients and their families must make a number of decisions about cancer treatment, some of which are more difficult than others. These decisions are complicated by unfamiliar words, various statistics, and a sense of urgency. However, it is important to allow time to research your options and ask questions. Decisions about cancer treatment are personal, and it is important that you feel comfortable about your decisions.

Learn about your cancer. Try to understand as much as you can about your cancer, such as its stage (a way of describing a cancer, such as where it is located and if it has spread to other parts of the body). The Cancer.Net Guides to Cancer are a good place to begin. If you are unfamiliar with certain words, ask your doctor or nurse or use a medical dictionary. Some people find it helpful to take notes during a doctor’s visit or bring a friend along to help keep track of all the information.

Know your options. Talk with your doctor about treatment options for your type and stage of cancer. Some of these options may include surgery, radiation therapy, chemotherapy, hormone therapy, active surveillance (watchful waiting), enrolling in a clinical trial, and not receiving treatment. People are often surprised to learn that they may have different treatment options.

Understand the goals of treatment. Often, cancer can be cured with treatment, called curative treatment. However, there are times when treatment is only used to relieve side effects, such as pain, and this is called palliative treatment. Knowing the goals of treatment helps people evaluate which risks are acceptable. For example, people who know their treatment is curative may be more willing to face potentially unpleasant side effects.

Learn about the risks and benefits of each treatment option. Different treatments have different risks, as well as potential side effects. An important part of making a decision is weighing the positives and negatives of each treatment option, including your ability to manage the side effects that are more common for the specific type of treatment. Factors to consider include the likelihood that the cancer will recur (come back) after treatment, the chances of living longer with or without treatment, the possibility of side effects, and your personal and family preferences.

Obtain a second opinion. Many people find that it helps to get a second or even third opinion from another oncologist and many doctors encourage it. Different oncologists may have different experiences with various treatments, and seeking multiple opinions may help you make a decision. Read more about types of oncologists. Also, learn more about seeking a second opinion.

Consult guidelines or other decision-making tools. Many cancer organizations, such as the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN), publish guidelines and treatment decision-making tools to help doctors and people with cancer understand various treatment options. One example is a decision aid tool developed by ASCO and Cancer Care Ontario for people with non-small cell lung cancer. Some cancer centers offer sophisticated statistical tools you can use with your doctor to help determine the best treatment option based on your personal medical information. Always use treatment guidelines and other programs with the help and interpretation of your doctor. Learn more about ASCO’s Patient Guides.

Talk about your decision with people you trust. Talk to your family, friends, a member of the clergy or spiritual advisor, an oncology social worker, and other people with cancer. What you decide is ultimately up to you, but some people find it helpful to talk through their concerns with other people. Many patient support organizations bring together people who have coped with similar experiences.

The role of statistics

Your doctor will probably mention many statistics when describing treatment options, including relative survival rates, disease-free survival rates, and progression-free survival rates. These numbers may be a good way to learn about how the treatment options differ, but they can’t predict how well the treatment will work in an individual. Your doctor can help you understand how these statistics relate to your treatment. Learn more about cancer statistics.

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Heart failure: Heart pumps help keep the beat

How does a heart pump work?

A bridge to recovery

Or sometimes a destination

Understand the risks

Living with a heart pump

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