Mechanical Circulatory Support
What is mechanical circulatory support?
People with advanced heart or lung failure may require mechanical circulatory support (MCS) to replace normal heart and lung functions. Often, these devices are implanted temporarily during an emergency surgical procedure following a heart event. Or, you doctor may recommend a MCS device as a long-term solution for advanced heart or lung failure.
MaineHealth employs the latest equipment and surgical therapies for cardiogenic shock and heart failure including mechanical circulatory support (MCS) devices such as extracorporeal membrane oxygenation (ECMO), temporary percutaneous ventricular assist devices to support both the right and left ventricles (VAD), durable implantable left ventricular assist devices (LVAD) and more.
Mechanical Circulatory Support Devices
Ventricular assist devices (also known as heart pumps) support blood flow and heart function in people with weakened hearts. The VAD helps move blood from the heart to vital organs throughout the body. Tubes carry blood from the heart to a mechanical pump and then from the pump to the blood vessels. There are two basic VAD designs.
- Transcutaneous: Pump and power source are outside the body. Small holes in the abdomen allow the tubes to run from the pump to the heart. This type of VAD is for short-term support.
- Implantable: The pump is inside the body and the power source is outside of the body. A cable runs through a small hole in the abdomen, connecting the pump to a portable power source, which can be worn on a belt.
A left ventricular assist device (LVAD) is a treatment option for certain patients with end-stage heart failure. Similar to a VAD, a LVAD is implanted in heart failure patients to help the heart’s left ventricle (major pumping chamber of the heart) pump blood throughout the body. The LVAD can be used two ways:
• Bridge-to-transplant: Helps transplant-eligible patients survive until a donor heart becomes available
• Destination therapy: Provides long-term support in patients who are not candidates for transplant
Who is eligible to receive a LVAD?
Your doctor will determine if a LVAD is an appropriate treatment for you, based on your medical condition, symptoms, age, body size and presence of other medical conditions. A LVAD may not be the appropriate treatment choice for some patients who have blood clotting disorders, irreversible kidney failure, severe liver disease, severe lung disease, or infections that cannot be treated with antibiotics.
Extracorporeal membrane oxygenation (ECMO) is a treatment modality that uses a mechanical pump and oxygenator to replace the function of the heart and/or lungs when a person's own organs are too sick to do the job. ECMO may support the body for a long period of time (days to weeks) to allow the heart and/or lungs time to rest. ECMO is indicated when there is a reversible cause of life-threatening respiratory or cardiac failure such as a heart attack or heart surgery. The use of ECMO has become more frequent at major medical centers around the world. Maine Medical Center offers ECMO services for both adult and pediatric care.