LVAD Implantation Peri and Post partum Cardiomyopathy (PPCM)
Women with PPCM are generally given a few months to recover before further intervention like ICD or LVAD are implanted. An LVAD is a heart pump that is operated with a battery that helps the heart to pump blood but unlike an artificial heart, it only helps the heart to do its job of pumping blood around the body. LVAD is abbreviated for Left ventricle assist device. Women with PPCM may have an LVAD implanted as a short term measure to give the heart a rest, a bridge to heart transplantation or destination therapy.
According to the Journal of Cariothoracic Surgery, there is "the possibility of improving recovery and prognosis in PPCM with early implantation of LVAD, perhaps also in moderately severe cases....However, LVAD-induced recovery in PPCM has only been described in a handful of patients and all with older pulsatile devices." See http://www.cardiothoracicsurgery.org/content/6/1/150#B8
There are no definitive answers about LVAD implantation and PPCM but if a patient has not improved heart function after several months, an LVAD is usually a suggested course of treatment.
What is an LVAD?
The LVAD is surgically implanted just below the heart with one end attached to the left ventricle and the other end is attached to the aorta, the body's main artery. A computer controller, a power pack, and a reserve power pack remain outside the body and these control the LVAD. The LVAD dramatically improves the quality of life for many patients, and relieve the symptoms of heart failure like shortness of breath, fatigue, and fluid retention.
However, there are also a number of risks. The risks associated with LVADs include: infection, mechanical failure of the LVAD, internal bleeding and heart failure.
- The line that goes into the abdominal wall is a source of potential infection. Infections can be treated with antibiotics but there are infections that are life threatening.
- LVADs require replacement and have a life span. They are mechanical device and like all mechanic devices are subject to failure
- formation of blood clots within the device that can cause stroke
- Kidney and Liver Dysfunction
- Right heart failure
- Depression or Anxiety
Outcomes for LVAD and PPCM
The video below is a video about a woman who developed Postpartum Cardiomyopathy (PPCM) and made the decision to have an LVAD implanted. She can now do most things apart from swimming and works in cardiac rehabilitation. She views the LVAD as a permanent solution to her heart problems.
In another case of PPCM, a woman had an LVAD implanted and nine months later had the LVAD removed. Her heart returned to normal size and function. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2612113/ The prognosis of having an LVAD implanted are unknown; some women's hearts may recover and they may have the device removed, some may continue to deteriorate and require heart transplantion and some may have their heart function stabalize. LVADs can be a bridge to recovery or bridge to heart transplant or destination therapy.
The video shows a PPCM survivor with her daughter and at work doing day to day things, and carrying the LVAD. At one point her two year old daughter helps her to change the batteries on the LVAD.
Myheartsisters.com has been developed to raise awareness about heart failure in pregnancy (PPCM) and provide support for heart sisters through storytelling and friendship. How to Join - Join as a heart sister, cardiologist or relative of a deceased heart sister and add yourself to a map and directory listing.