Ventricular Assist Device

A ventricular assist device (VAD) is a mechanical pump that helps the lower part of your heart (ventricles) pump blood. A person may need a VAD due to:

  • Heart failure.

  • A heart attack.

  • A viral illness that has attacked the heart muscle.

PARTS OF A VENTRICULAR ASSIST DEVICE

  • The parts of a VAD are:

  • Inflow tube-brings oxygenated blood from the left ventricle to the pump.

  • Outflow tube-brings blood from the pump to the aorta. The aorta is a large artery that takes oxygenated blood to your body.

  • Pump. This is implanted into the body.

  • Drive line (percutaneous lead). This tube connects the pump to the system controller.

  • System controller. This consists of batteries and the electronics which control the device.

The VAD is powered by either batteries or an electrical wall outlet.

A VENTRICULAR ASSIST DEVICE PUMPS BLOOD IN ONE OF TWO WAYS

  • Pulse flow-The VAD pumps or "pulses" blood through the VAD.

  • Continuous flow-Blood is continuously cycled through the VAD. You may not feel a "pulse" when your blood is continuously ran through the VAD.

TYPES OF VENTRICULAR ASSIST DEVICES

There are different types of ventricular assist devices. Most VAD's are implanted into your heart. Your caregiver will determine which type of device you need based on your type of heart failure and medical condition:

  • Left Ventricular Device (LVAD). This is the most common type of VAD. It helps the left ventricle pump blood to the aorta. The aorta is a large artery that carries blood to the rest of the body.

  • Right Ventricular Device (RVAD). This type of VAD helps pump blood from the right ventricle to the lungs. An RVAD is used if you have right sided heart failure. It may only be used for a short time.

  • Biventricular Assist Device (BIVAD). This type of VAD combines an LVAD and an RVAD. The two are used together to help the right and left ventricle pump blood.

  • Transcutaneous VAD: With this type of VAD, it is used in emergency situations or when it will not be needed for a long time. The pump is outside the body. It is sometimes called a "bedside" VAD.

VENTRICULAR ASSIST DEVICE USES

  • A VAD may be used to "rest" the heart after a viral heart infection.

  • Bridging therapy-supports a patient until a heart transplant becomes available.

  • Destination therapy-this supports a patient who has end stage heart failure and is not a candidate for a heart transplant.

  • A VAD can improve heart function in some patients with end stage heart failure. If heart function improves, it is possible the VAD can be removed.

IMPLANTING A VENTRICULAR ASSIST DEVICE

  • Open heart surgery is needed to implant a VAD.

  • After the VAD is implanted, you will go to intensive care unit (ICU). Expect the following:

  • You will be on a breathing machine (ventilator). It will be removed when you are strong enough to breath on your own.

  • You will have a lot of tubes after the surgery. You will have a tube draining your bladder (catheter). A tube in your chest (chest tube) will drain fluid from around your heart. You will have IVs (intravenous) lines to give fluids and medications.

  • Pain medicine will be given to keep you comfortable.

VENTRICULAR ASSIST DEVICE CARE

The care you will need with a VAD will vary. This depends on the type of VAD you have and your medical condition. You can expect the following:

  • You may need a continuous hospital stay with a VAD.

  • Support from different health care professionals such as:

  • A heart specialist (cardiologist).

  • A dietician for nutritional support.

  • A physical therapist.

  • A social worker.

  • Medications. You will be on medications including blood thinners, heart medications, or antibiotics.

VENTRICULAR ASSIST DEVICE RISKS AND COMPLICATIONS

With any type of VAD, problems can occur during implantation, after implantation or when living at home with the VAD. Complications can include:

  • Infection:

  • Bacteria can get into the VAD tubing and cause an infection.

  • After implantation of a VAD, an infection can also affect different body organs such as the lungs and kidneys.

  • Bleeding:

  • People with a VAD need to take blood thinners. These medications prevent blood clots in the VAD tubing. You will need blood work often to monitor the blood thinner medication.

  • Bleeding can occur because of the blood thinner medication.

  • Blood Clots:

  • Even with blood thinner medication, there is still a risk of a blood clot developing.

  • Blood clots can clog the VAD and keep it from working properly.

  • Stroke. Two types of stroke can happen:

  • A stroke caused by a clot.

  • A stroke caused by bleeding into the brain (hemorrhagic stroke). This type of stroke can be caused by blood thinner medication.

  • VAD malfunction:

  • Mechanical complications can occur with a VAD. It is important to understand how your VAD works and what alarm functions mean.

VENTRICULAR ASSIST DEVICE SUPPORT

  • A VAD coordinator will provide support and education.

  • A person must be able to live independently when discharged home with a VAD device.

  • It is important to live near the hospital where the VAD was implanted. Patient's who are discharged home with a VAD will need close follow-up care and support.

SEEK IMMEDIATE MEDICAL CARE IF:

  • An unexplained temperature above 102° F (38.9° C) develops.

  • You have shortness of breath (SOB) or difficulty breathing.

  • You have chest pain, or pain that spreads to your arm, neck, jaw, back, or belly (abdomen).

  • You have blood in your sputum, vomit, or stool.