(Ventricular Assist Device; VAD)
Definition
Definition
A heart assist system implantation is an artificial heart. It is also called a ventricular assist device (VAD). This single-chamber artificial heart works by compressed air or battery power. The device boosts the function of a failing heart ventricle.
Left Ventricular Assist DeviceCopyright © Nucleus Medical Media, Inc.
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Reasons for Procedure
Reasons for Procedure
Heart failure occurs when the heart is too weak to pump all the blood it receives and blood begins to back up. Blood can back up into the lungs and into the lower parts of the body. This can cause trouble breathing, cough, and swelling of the legs and ankles.
Getting a VAD is a way to improve the heart’s ability to pump without having a heart transplant. A VAD is sometimes referred to as a bridge to transplant, since it can be used while a person is waiting for a heart transplant. This device can also be used for permanent treatment in people who:
- Are not candidates for transplant
- Do not respond to standard treatment
- Have a low risk of surviving 1 year
Possible Complications
Possible Complications
If you are planning to have VAD implantation, your doctor will review a list of possible complications, which may include:
- Bleeding
- Blood clots
- Infection
- Device failure
- Adverse reaction to the anesthesia
- Kidney, lung, or heart damage
Factors that may increase the risk of complications include:
- A serious infectious disease
- Advanced disease of vital organs other than the heart
- Blood clotting disorder
- Excessive alcohol consumption
- Smoking
Also, if you have a small stature, you may not be able to get a VAD due to the size of the device.
Be sure to discuss these risks with your doctor before the surgery.
What to Expect
What to Expect
Prior to Procedure
If you need a VAD, it is because your heart is failing. Most likely, you will be on a list to receive a heart transplant. You may already be in the hospital. Your doctor will do many tests, including:
- X-ray
- Echocardiogram—size, shape, and motion of the heart are examined
- Cardiac Catheterization—to look for coronary artery disease
- Psychological and social system evaluations to make sure you are prepared to manage the device outside of the hospital
Leading up to the procedure, your doctor will instruct you to:
- Avoid eating for 8 hours before the procedure
- Stop taking certain medications for 1 week before surgery.
Anesthesia
General anesthesia will be used. It will block any pain and keep you asleep through the surgery.
Description of the Procedure
This procedure involves open heart surgery. An incision will be made down the length of your breast bone. The breast bone will then be split and separated. You will be placed on a heart-lung machine. This machine will take the place of your heart and lungs during the surgery. The VAD will be placed into a pocket on the inside of the abdominal wall. Tubes will be sewn to your heart. Tubes may also be sewn to your aorta, depending on the type of device.
Immediately After Procedure
You will be in the intensive care unit (ICU) after the procedure. You will be connected to many tubes. The medical staff will monitor you.
How Long Will It Take?
About 4-8 hours
How Much Will It Hurt?
You will have pain from the surgery. Ask your doctor about medications to help with the pain.
Average Hospital Stay
- 2-5 days in the ICU
- 2-4 weeks in a regular hospital room
Postoperative Care
At Home
When you return home, do the following to help ensure a smooth recovery:
- Stay in contact with the heart center. You may be waiting for a heart transplant.
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Be sure to follow your doctor’s instructions. Instructions will include:
- How to take care of your VAD
- When to contact the hospital—Make sure that you know how to call your doctor if you have an emergency.
Call Your Doctor
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, excessive bleeding, or any discharge from the incision site
- Increasing pain
- One-sided weakness, blurry vision, or inability to talk
- A cold, pale or blue, numb, or painful extremity
- Cough, difficulty breathing, or chest pain
- Nausea, vomiting
- Problems with urination or bowel movements
- Redness or swelling in legs.
- Warning indications from the device
In case of an emergency, call for emergency medical services right away.
RESOURCES:
United States Food and Drug Administration http://www.fda.gov
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada http://www.heartandstroke.com
References:
Slaughter M, Milano C, et al. Advanced heart failure treated with continuous-flow ventricular assist device. N Engl J Med. 2009; DOI:101056/NEJMoa0909938.
Ventricular assist devices (VAD). Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/heart/disorders/heartfailure/lvad_devices.aspx
Updated February 2015. Accessed June 30, 2015.
3/6/2013 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Peura JL, Colvin-Adams M, Francis GS, et al. Recommendations for the use of mechanical circulatory support: device strategies and patient selection: a scientific statement from the American Heart Association. Circulation. 2012;126(22):2648-2667.
Last Updated: 5/11/2013