LVAD Surgery: What It Is, Who Needs It, and the Heart Failure Care Acibadem Offers Instead

Important note: Acibadem hospitals do not perform LVAD (left ventricular assist device) implantation. This page explains what an LVAD is, who it is for and what implantation involves, so that patients and families can understand the option. It then describes the advanced heart failure care that Acibadem’s cardiology and cardiovascular surgery teams do provide, and how we help patients who may need an LVAD or a heart transplant plan their next step.

What an LVAD Is and When It Is Considered

A left ventricular assist device is a mechanical pump that is surgically connected to the heart’s main pumping chamber, the left ventricle. It draws blood from the ventricle and delivers it to the aorta, taking over part of the work that a severely weakened heart can no longer do on its own. The pump is powered through a cable (the driveline) that passes through the skin to a controller and batteries worn outside the body.

LVADs are considered only in advanced (end-stage) heart failure, when symptoms remain severe despite optimised medication and, where appropriate, device therapy. They are used in two situations: as a bridge to transplantation, keeping a patient stable while a donor heart is awaited, and as destination therapy, meaning long-term support for patients who are not candidates for a transplant. The decision belongs to a specialised advanced heart failure team and depends on the cause of the heart failure, the function of the right ventricle, kidney and liver function, age, other illnesses and the patient’s own wishes.

Understanding Heart Failure and Mechanical Circulatory Support

Heart failure means the heart cannot pump enough blood to meet the body’s needs. In its early stages it is managed with medicines, lifestyle changes and treatment of the underlying cause, such as blocked coronary arteries, valve disease or an abnormal rhythm. Many patients remain stable for years on this care.

When the heart muscle continues to weaken, breathlessness, fatigue and fluid retention persist even at rest, and organs such as the kidneys and liver begin to suffer from poor blood flow. At this point clinicians speak of advanced heart failure. Mechanical circulatory support, of which the LVAD is the most established form, is one of the options reserved for this stage; heart transplantation is the other.

It is important to know that most patients with heart failure never reach this stage, and that a diagnosis of advanced heart failure does not automatically mean an LVAD is needed. A full reassessment often identifies treatable causes or gaps in therapy that can still make a difference.

What Acibadem Offers Patients With Advanced Heart Failure

Acibadem’s cardiology departments and cardiovascular surgery units treat patients with all stages of heart failure. We do not implant LVADs, but for patients whose heart failure is advanced, and for patients who have been told abroad that they may need an LVAD, we offer the following:

• A complete reassessment. Echocardiography, cardiac catheterisation where indicated, rhythm monitoring and blood tests establish how the heart is functioning now and whether a treatable cause is present. See echocardiography and heart failure treatment.
• Optimised medical therapy. Modern heart failure medicines, adjusted step by step and monitored closely, improve symptoms and survival in many patients whose treatment was never fully optimised.
• Treatment of the underlying cause. Where narrowed coronary arteries are contributing, coronary stenting or bypass surgery can restore blood supply to the heart muscle. Where a leaking or narrowed valve is the driver, options include valve repair or replacement surgery, TAVI for a narrowed aortic valve and MitraClip for mitral regurgitation, performed through a catheter without open-heart surgery.
• Rhythm treatments. Abnormal rhythms that worsen heart failure can be treated with ablation and, where indicated, pacemaker procedures.
• Minimally invasive and robotic cardiac surgery for suitable patients, which shortens recovery compared with conventional open surgery.
• Cardiac rehabilitation, a supervised programme of exercise, education and risk-factor management that improves functional capacity and quality of life.

If, after this assessment, our cardiologists conclude that an LVAD or a heart transplant is the right option, they say so clearly. We provide a written report of the findings and treatment given so far, so that the patient can take it to a specialised mechanical circulatory support or transplant programme, and we continue to support the patient’s general cardiac care as needed. We do not promise an operation we do not perform.

How LVAD Implantation Is Performed

At centres that offer the procedure, LVAD implantation is an open-heart operation carried out under general anaesthesia by a cardiac surgery team with a perfusionist, anaesthetist and intensive care support. The chest is opened, the pump’s inflow is connected to the tip of the left ventricle and its outflow graft is sewn to the aorta. The driveline is tunnelled under the skin and brought out through the abdominal wall, where it connects to the external controller. Once the pump is running and blood flow is confirmed, the chest is closed and the patient is transferred to intensive care.

The operation usually takes several hours. The first days are spent in intensive care, followed by a stay on a cardiac ward that commonly lasts two to three weeks in total, during which the patient and family are trained to manage the controller, batteries and driveline dressing.

Preparation and Testing Before an LVAD

Because the pump supports only the left side of the heart, the evaluation before implantation focuses on whether the right ventricle can cope with the increased blood flow, and on the condition of the kidneys, liver and lungs. Typical tests include echocardiography, right heart catheterisation to measure pressures in the heart and lungs, blood tests, imaging and an assessment of the patient’s ability to manage the device at home. Nutrition, frailty and psychological readiness are also part of the evaluation. These same tests are part of the advanced heart failure assessment carried out at Acibadem, and the results are useful whichever treatment path a patient eventually follows.

Recovery and Life With an LVAD

Recovery after implantation combines physical rehabilitation with learning a new daily routine. Patients must keep the driveline exit site clean and the dressing dry to reduce the risk of infection, carry charged spare batteries and a backup power source at all times, and take anticoagulant medication exactly as prescribed to prevent clots forming in the pump. Regular follow-up visits allow the LVAD team to check the pump’s function, adjust its settings and review blood tests.

Most patients regain the ability to walk, climb stairs and carry out everyday activities that had become impossible. Swimming and contact sports are not possible with an external driveline, and heavy lifting is restricted while the chest heals. With good self-care and regular follow-up, many patients live with an LVAD for years.

Risks and Possible Complications

An LVAD is major surgery in patients who are already seriously ill, so the risks are real and should be discussed openly. The most important complications are bleeding, driveline or pump-pocket infection, blood clots and stroke, pump thrombosis, right heart failure after implantation and, less commonly, device malfunction. Careful patient selection, meticulous surgical technique, strict anticoagulation management and thorough patient education reduce these risks but do not remove them. Patients should ask any centre offering the procedure about its own experience, infection rates and long-term outcomes.

LVAD Versus Heart Transplantation

Heart transplantation replaces the failing heart with a donor organ and remains the treatment with the best long-term outcomes for suitable patients, but it depends on the availability of a donor heart and requires lifelong immunosuppression. An LVAD supports rather than replaces the heart, can be implanted without waiting for a donor and avoids immunosuppressive drugs, but it brings the device-related risks described above and the practical demands of living with external equipment.

For some patients an LVAD is a bridge to a later transplant; for others, particularly older patients or those with conditions that rule out transplantation, it is a long-term treatment in its own right. Which path is appropriate is a decision for an advanced heart failure team that has all the test results in front of it.

Costs: What to Expect

Because Acibadem does not perform LVAD implantation, we do not quote prices for it. Internationally, the cost of an LVAD includes the pre-operative evaluation, the device itself, the operation, intensive care and ward stay, rehabilitation and lifelong follow-up, and it varies widely between countries and centres. Patients should ask for a written, itemised estimate from any programme they consider.

For the heart failure assessment and the treatments Acibadem does provide, our international patient team prepares a written cost estimate before travel, based on the medical records and imaging the patient shares with us. Consultation, testing, procedures and hospital stay are itemised, so there are no surprises, and we explain what is and is not included.

Support for International Patients

Patients who travel to Acibadem for cardiac assessment or treatment are supported by an international patient team that coordinates the transfer of medical records and imaging, arranges appointments and hospital admission, and helps with visas, airport transfers and accommodation. Interpreters are available, and every patient receives a written treatment plan and a discharge report for their doctors at home. Patients who have been advised to consider an LVAD abroad can use this pathway to obtain a second opinion from our cardiologists before deciding.

Next Steps

If you or a family member have advanced heart failure, or have been told that an LVAD may be needed, share your recent reports and imaging with our international patient team through the free consultation form. A cardiologist will review whether the treatments available at Acibadem can help, and will tell you honestly if a mechanical circulatory support or transplant programme elsewhere is the right next step. This page is general information and does not replace an individual assessment by a cardiologist.

FAQ

Q: Does Acibadem perform LVAD surgery?

A: No. Acibadem hospitals do not implant left ventricular assist devices. Our cardiology and cardiovascular surgery teams assess patients with advanced heart failure and offer the treatments that apply to their condition, and they tell patients clearly when an LVAD or a heart transplant programme elsewhere is the appropriate next step.

Q: What can Acibadem offer a patient who has been told they need an LVAD?

A: A full reassessment of the heart failure, optimisation of medical therapy, and treatment of causes that may still be correctable, such as coronary artery disease, valve disease or rhythm problems, through stenting, bypass surgery, valve surgery, TAVI, MitraClip, ablation or pacemaker procedures. Cardiac rehabilitation is also available. If none of these is sufficient, we provide a written report to support referral to a specialised programme.

Q: How does an LVAD help patients with end-stage heart failure?

A: The pump takes over part of the left ventricle’s work, restoring blood flow to the organs, relieving breathlessness and fatigue and allowing many patients to return to everyday activities. It can serve as a bridge to transplantation or as long-term (destination) therapy.

Q: What tests are needed before an LVAD?

A: Echocardiography, right heart catheterisation, blood tests of kidney and liver function, imaging and an assessment of the patient’s ability to manage the device at home. The condition of the right ventricle is especially important. Acibadem performs this type of advanced heart failure assessment even though it does not implant the device.

Q: What happens during LVAD implantation?

A: At centres that perform it, the operation is open-heart surgery under general anaesthesia. The pump is connected to the left ventricle and the aorta, the driveline is brought out through the skin to an external controller, and the patient recovers first in intensive care and then on a cardiac ward.

Q: How long is recovery after an LVAD?

A: Typically a few days in intensive care followed by a ward stay, with a total hospital stay of around two to three weeks, during which patients and families learn to manage the equipment. Rehabilitation continues after discharge and regular follow-up is lifelong.

Q: What are the most common LVAD complications?

A: Bleeding, driveline infection, blood clots and stroke, pump thrombosis, right heart failure and device malfunction. Strict anticoagulation, careful wound care and prompt review of any alarm or symptom reduce the risks.

Q: How much does an LVAD cost?

A: Acibadem does not perform the procedure and therefore does not quote LVAD prices. Elsewhere, the cost covers evaluation, the device, surgery, intensive care, rehabilitation and lifelong follow-up, and varies widely by country and centre. For the heart failure care Acibadem does provide, we give a written, itemised estimate before travel.

Q: How does an LVAD compare with a heart transplant?

A: A transplant replaces the heart and offers the best long-term results for suitable patients, but depends on a donor and requires lifelong immunosuppression. An LVAD supports the heart, can be implanted without waiting for a donor and avoids immunosuppressive drugs, but carries device-related risks and the demands of living with external equipment.

Q: Does Acibadem support international patients with heart failure?

A: Yes. Our international patient team coordinates records, appointments, travel and interpreters, and our cardiologists provide second opinions for patients who have been advised to consider an LVAD abroad.