Dr. Parmita S. Desai, senior field clinical manager, of Abbott’s heart failure business in India, walks us through a 17-year-old’s journey after heart failure.
Manish (name changed) is now 18. But there was a time, not very long ago, that he wasn’t sure about the journey ahead. As someone who had an active life with school and friends, he was far too busy to consider illness was even possible. One day, as he was participating in a sports activity, he felt fatigued. He didn’t think much of it till this deteriorated to weakness even while walking.
Initial medical tests failed to diagnose the problem and Manish gradually needed a wheelchair to move around, causing limitations in his everyday life. After multiple tests, he was told that his young heart was pumping at only 10 percent of its capacity, and he was diagnosed with heart failure. Nothing the doctors did seemed to make a substantial impact, and Manish was told that he would need a heart transplant.
Unfortunately, there just aren’t enough hearts available for every person in need of a transplant. Manish as well as his healthcare team knew that the chances of finding a suitable heart for a transplant in time were remote. In the meanwhile, his condition continued to decline. That’s when his doctor suggested that he should be implanted with a Left Ventricular Assist Device (LVAD). The LVAD is a mechanical heart pump that’s implanted in the chest, attached to the actual heart, to help pump blood for the weakened muscle. The device allows more oxygen-rich blood to flow throughout the body. Manish is the youngest person in India to undergo this procedure and today, he is moving ahead in his journey – beyond heart failure.
India has one of the highest incidences of cardiovascular diseases cardiovascular disease (CVD). In the country, the estimate for people with heart failure range between 1.3 and 4.6 million each year, although this may be underestimated. However, contrary to popular belief, heart failure does not indicate that the heart has stopped working completely. It means that the heart function has been compromised. It is possible to manage this condition through early diagnosis and proper medical intervention.
The LVAD, short for Left Ventricular Assist Device, is a type of mechanical heart pump that is surgically implanted in the chest. It is connected to the natural heart and assists in pumping blood when the heart muscle is weakened or unable to function properly | Shutterstock
That’s where the LVAD fits in. Implanted through open heart surgery, the device pumps blood from the lower chambers of the heart to the rest of the body when the heart is too weak to do so on its own. It can also act as a “bridge” therapy for patients – keeping them alive while awaiting a heart transplant. Since heart transplants are governed by external factors such as eligibility of the patient and availability of organs, LVADs have become a life-prolonging option. This technology can have a positive impact on patients by slowing the progression of heart failure. Data have shown nearly 60% implanted patients survived five years and beyond.
In 2018, the U.S. Food and Drug Administration (FDA) approved the LVAD for destination therapy, making it the first such device authorized to provide permanent support for heart failure patients. With advances in technology, LVADs have become increasingly smaller, more discreet with advanced battery technology and more efficient. The device also has features that allow doctors to adjust pumping speeds based on patient needs. LVAD technology will continue to become more sophisticated, allowing future mechanical pumps even more versatility.
Patients with LVADs experience significant improvement in their quality of life, including the ability to engage in physical activities and social interactions. They can enable patients to regain mobility and freedom by providing continuous support to the heart.
For Manish, heart failure is no longer a daunting diagnosis, but a manageable condition with the support of his LVAD. It lets him live his daily life free of heart failure symptoms. One day, maybe he will get a new heart. For now, LVAD in place, and spirits high, he’s gotten back to doing the things he loves.
(As told to Puja Awasthi)