Mechanical circulatory support includes various pumps whose role is to help a severely weakened heart to pump blood towards the other parts of the body. Each device which provides mechanical circulatory support consists of 3 basic components:
- a pump that is implanted inside the body (implantable pump) or located outside of the patient’s body (paracorporeal pump)
- control unit located outside of the patient’s body, which programs and monitors the operation of the pump and
- external power sources – portable batteries or power supply consoles.
Implantable pumps assist heart function over a longer period of time. These include LVAD (pump that takes over the role of the left ventricle) and TAH (pump that takes over the role of both chambers, i.e. total artificial heart).
LVAD is the most common implantable pump that permanently takes over the role of the left ventricle. It is administered as the definitive therapy in case of the most severe forms of cardiac insufficiency, but also as a transitional solution in those patients who are on the transplant list, and who require mechanical circulatory support due to the heart function deterioration. LVAD is surgically implanted and remains inside the chest. The only communication with the external environment is established via the power cable that connects the pump to the external batteries. The batteries are carried around the waist or in a small backpack, thus giving the patient long-term mobility. Depending on the general health, the patient can return to his/her professional activities and other areas of daily life. Modern LVADs are small in size and enable long-term survival. It is very important that the patient appears for regular check-ups after the LVAD implantation. In the beginning, these check-ups are more frequent, and later on they are adjusted to the needs of the patient. Paracorporal (out-of-body, non-implantable) pumps are most often used to support the heart for a shorter period of time until it recovers or until a permanent pump is implanted. Intra- aortic balloon pump and extracorporeal membrane oxygenation (ECMO) are examples of such pumps. They are used exclusively in hospital environment.