As with any surgery or procedure, there are risks and the possibility of complications with the VAD/ LVAD implantation surgery. These include risks related to the surgery, risks of undergoing anesthesia, and risks related to the VAD itself. On average, properly selected patients after detailed evaluation feel better and live longer with the VAD. However, there could be a few individuals who might have complications during and after the surgery. Our medical team will discuss the risks in detail with the patient and family. Here is a list of risks with the VAD implantation surgery.
Short-Term Risks around the time of surgery:
Risks which are likely, and could be serious:
- Discomfort after surgery similar to any major heart surgery
- Right-sided heart failure and/or failure to increase blood flow, resulting in ongoing symptoms of heart failure
Less likely risks, but, are usually serious:
- Need for re-operation (surgery)
- Kidney failure, potentially with a need to start dialysis
- Lung failure, possible need to remain on a mechanical breathing machine (ventilator)
- Blood clots that can travel to other parts of the body; this could result in stroke or loss of a limb or organs
- Liver failure
Longer-Term Risks after the surgery:
- Bleeding: Nose bleeds, which can be severe enough to require medical help. Stomach or intestinal bleeds. Bleeding is very common because
1. Patients with VADs require some form of blood-thinning medication to
reduce the risk of clot-forming in the pump
2. Many VAD’s affect the body’s natural ability to prevent bleeding
- Blood clots: Clots in the device make it malfunction, leading to other problems and may require major surgery to replace the device.
- Disturbances in thinking or emotions, behavioral changes
- Ongoing pain, particularly discomfort around the area that the driveline (power cord) exits your body
- Device malfunction and need for re-operation (surgery)
- Decrease in quality of life, either from complications or from the natural limitations and ongoing care required of the VAD
- Caregivers (spouse, family, friend) may experience increased stress and caregiving responsibilities
In particular, bleeding, stroke, and infection of the VAD are common risks which could also be life-threatening.
Our medical team including the surgeon will discuss all the risks with you in detail. The patient, caregiver, and family need to understand the risks in detail before deciding about the surgery.
THE VAD IMPLANTATION SURGERY
The surgery to implant the VAD will be open-heart surgery and can take between 6-12 hours. The surgeon will make an incision (cut) down the front of your chest to reach the heart. You will have a breathing tube and be under general anesthesia. In all cases, you will be on a heart/lung machine during the surgery. The VAD is placed below the heart and the surgeon will connect the pump to the heart and secure it in place. Once the pump is in place, the VAD and the heart will together pump blood through your body. After the surgery is completed, you will return to the intensive care unit.