Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Houston Methodist DeBakey Heart & Vascular Center

End-Stage (Stage D) Heart Failure

Sometimes heart failure progresses to a point where treatment is not effective and the patient progresses to Stage D of the disease. Patients at this stage typically need either a left ventricular assist device (LVAD) or a heart transplant.

Left Ventricular Assist Device (LVAD)

A left ventricular assist device (LVAD), often called a heart pump, is an implanted mechanical device that helps maintain the pumping ability of a heart that can not effectively work on its own. Unlike an artificial heart, the LVAD is not used to "replace" the heart; it just helps the heart do its job more effectively.

HeartMate II LVAD (image courtesy of Thoratec Corp.) HeartMate II LVAD (image courtesy of Thoratec Corp.)

For some patients, an LVAD can provide the heart with some mechanical assistance to help restore its normal function. In cases of end-stage heart failure, an LVAD can serve as:

  • A temporary solution while waiting for a transplant (a "bridge to transplant")
  • A way to improve the quality of life and survival for terminally ill patients who are not candidates for a heart transplant

An LVAD is implanted during open-heart surgery. The pump is placed just below the diaphragm, with one end attached to the left ventricle (the chamber that pumps blood to the body) and the other attached to the aorta (one of the body's main arteries attached to the heart). Blood flows from the left ventricle into the pump; when the pump's sensors indicate it is full, it pumps the blood out to the aorta.

The LVAD is attached to an external controller and power pack, which reside outside the body and are connected to the pump by a tube called a driveline. The power pack will need to be recharged every night.

Heart Transplant

In a heart transplant, a failing heart is replaced with a healthy heart from a generous donor who has recently passed away. It is generally reserved for patients who have tried medications or other surgeries, but their heart failure has not improved.

Sometimes a donor heart is not available right away. As a "bridge to transplant," LVADs can help a weakened heart to pump more blood while the patient waits for a donor organ.

Ever since Dr. Michael E. DeBakey performed his first heart transplant in 1968, Houston Methodist has led the way in heart transplants and the advancement of devices that support heart failure patients while they wait for transplantation.

Houston Methodist Hospital's heart program is unique in that we offer multi-organ transplantation to patients suffering from dual-organ end-stage disease, and we carefully evaluate and offer treatment for disease-specific end-stage cardiomyopathies. Since January 2012, Houston Methodist surgeons have performed 33 heart and heart multi-organ (heart-liver, heart-kidney, heart-lung) transplants. Our average one-year survival rate for heart and multi-organ transplant is almost 90%*. Also, in 2011, 94.8% of our heart transplant patients rated our service as "exceptional," a testament to the expertise of our surgeons and the compassionate care of our staff.

* Based on the past three years (2009-2011), average one-year survival rate is 89.65%.

To learn more about heart transplants at Houston Methodist, visit Methodist J.C. Walter Jr. Transplant Center website or call 713-441-5451.

For more information about heart failure treatment at the Houston Methodist DeBakey Heart & Vascular Center or to make an appointment, please call us at 713-DEBAKEY (713-332-2539) or complete our online contact us form.