LVAD – Resus & Troubleshooting

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LVADs (Left Ventricular Assist Device) are becoming more common and there are patients in our region with them as a bridge to transplant or recovery and in some cases a destination therapy.

The patient and their family will likely know more about this device than you and should have brought spare parts. Our local LVAD centre is Wythenshaw however, there are other units around the country the patient may direct you to.

The patient may not have a palpable pulse, the blood pressure will be low and the heart pump sounds like a buzz when you listen.

If patient is unresponsive or has a history of collapse its important to troubleshoot the device and resusitation may be required

Algorithm 1

Algorithm 2

Algorithm 3

Hypovolaemia may be recognised by the display showing low LVAD flow (<3 //min), with or without an audible alarm – Give fluid bolus and raise legs (in hypovolaemia the pump can suck the ventricle shut)
LVAD thrombosis could present in 2 ways
- Outflow obstruction low LVAD flow despite euvolaemia
- Impeller/Pump thrombus leads to a false “high” LVAD flow (>3l/min) display on the controller
- If thrombus suspected contact LVAD centre