Another option for patients struggling with Advanced Heart Failure could be a Left Ventricular Assist Device (LVAD). An LVAD is a small mechanical pump that a surgeon attaches to the heart which then restores a better circulation to the rest of the body. Due to their high cost, the NHS currently restricts the use of these pumps to patients who are transplant listed but might not survive the wait to receive a donor heart. We term the use of the LVAD in this situation a "bridge to transplant".
Around the world approximately half of all patients having an LVAD are having them implanted as "Destination Therapy." This means the pumps are being implanted as a lifelong therapy irrespective of the eligibility for transplant. At present the NHS does not fund Destination Therapy LVADs and therefore they can only be implanted through self pay under these terms.
In the right circumstances LVADs can gift a patient with both relief of symptoms and a number of years of additional life (when otherwise they would die). Similar to transplant, this is major open heart surgery and is not a treatment suitable for everyone and there can be complications. Dr Shaw is one of the few Heart Failure cardiologists in North West England with expertise in assessing patients for LVAD and managing them over the long term. He has looked after close to 100 patients with Heartmate 2, Heartware and Heartmate 3 pumps.
MBChB MRCP PhD
Heart Transplantation is a surgical option for some patients. It is a celebrated treatment worldwide, as it can offer a truly excellent chance of survival and restoration of health in carefully selected individuals. Dr Shaw helps select patients for transplant and looks after them in his NHS work at Wythenshawe Hospital. However, the donor shortage in the UK means that the eligibility criteria is tight. It is unusual for transplantation to be offered after the age of 65 or if you have any other significant medical problems. Also some patients do not wish to have a transplant due to their beliefs or concern over the risks of immunosuppression (infection, cancer). Transplantation is not an easy treatment option and it is associated with several risks / complications. Depending on the age of the recipient, it may not be able to restore a normal life expectancy. However, the for the majority of recipients it has been a truly remarkable operation that has given hope of a future back to them after they thought it was lost.
The main treatments for Heart Failure are medications, lifestyle changes and in certain cases pacemaker devices. However, some patients do not improve despite these treatments and the condition can get progressively worse. In these circumstances, we often call the diagnosis Advanced Heart Failure. This is a worrying time for patients and families because the prognosis can be poor. Dr Shaw is one of the leading UK cardiologists for Advanced Heart Failure and he can provide an expert assessment to determine the prognosis and find out whether any other options are available to you.