What is a ventricular assist device (VAD)?
A ventricular assist device, also commonly known as a VAD, is a mechanical pump used in patients with weakened hearts. A VAD will help pump oxygen-rich blood from the right or left ventricle (lower chambers of the heart) to the body.
A VAD is typically used on patients who have late-stage heart failure. It can be placed in the left or right ventricle, but most frequently it is used in the left ventricle. When a VAD is placed in the left ventricle, it is called a left ventricular assist device (LVAD).
A VAD in some patients may be able to restore the failing heart and eliminate the need for a heart transplant.
Who is a candidate for a ventricular assist device?
Your Mercy Health cardiac team will perform a series of tests on you to determine your overall health before deciding if you are a candidate for a VAD. Testing may include:
- Chest X-ray
- Electrocardiogram (ECG)
- Cardiac catheterization
There are two categories of candidates for ventricular assist devices:
- Patients who need a temporary solution until they can have a heart transplant — these patients are referred to as bridge-to-transplant candidates
- Patients who are not candidates for heart transplant and need the device to support their heart function for life
Heart failure patients who are candidates for a ventricular assist device as a bridge-to-transplant include:
- Patients with severe heart failure who may have a long wait for a donor heart
- Patients who suffer from advanced heart failure with other comorbidities that impact the heart’s function
Patients who are candidates for a VAD as destination therapy include:
- Patients who suffer from severe heart failure who are not candidates for a heart transplant and all other treatments have failed
- Patients who have a left ventricular ejection fraction of less than 25 percent
Destination therapy may not be appropriate for some candidates such as those with:
- Blood clotting disorders
- Late-stage, irreversible kidney failure
- Severe lung disease
- Infections that can’t be treated with antibiotics
How does a ventricular assist device work?
A VAD is surgically implanted in the sac around the heart (pericardial space). The VAD is connected to the bottom of the left or right ventricle. The device draws blood from the ventricle and delivers it to the aorta where it can be pumped to the rest of the body. Your doctor can program the device to deliver the precise amount of blood your body needs. The pump is connected to a controller outside the body that monitors the pump via a small cable.
What are benefits of having a ventricular device?
Having a VAD implanted can help you improve your quality of life. You may have more energy, more strength and breathe better. Most patients with an VAD have a longer life span compared to other end-stage heart failure patients who do not get a VAD. Patients can use a VAD for as long as seven years.
What are risks associated with implanting a ventricular assist device?
It is important to have VAD surgery with an experienced cardiac team because the VAD implantation procedure is risky, and complications can be fatal. Risks include:
- Developing blood clots
- Severe bleeding
- Infection at the incision site
- Right heart failure
- Device malfunctions that limit the amount of blood pumped to the body
Recovery from ventricular assist device implantation surgery
Recovery from a VAD surgery is carefully monitored. You will spend a few days in the ICU after the procedure to ensure your device and vital organs are working properly. Once cleared from the ICU, you will be moved to a regular hospital room to recover. The time you spend in the hospital will depend upon how well your body is functioning and your overall health. Some patients may need extra supervised care after being discharged from the hospital.
You may take antibiotics or blood thinning medications to prevent infection or blood clots.
Since VADs are portable, most patients return to their normal day-to-day activities while waiting for their heart.