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Ventricular Assist Devices

A Ventricular Assist Device (VAD) is a mechanical pump placed during surgery. It takes over the pumping action of one or both of the heart’s ventricles. It is used for patients with severe heart damage whose hearts cannot properly pump oxygen-rich blood to the body. VADs increase survival and improve function in end-stage heart failure patients. Most often, this treatment is used in one of two ways.

• Bridging a Patient to Heart Transplantation: A VAD may be implanted if heart function is so poor, that a patient listed for heart transplant may not survive until a donor heart is found. The VAD is removed just before heart transplant surgery.
• Destination therapy: VADs may also be implanted in end-stage heart failure patients who are not candidates for heart transplant. The VAD is then implanted permanently. To understand VADs, it is helpful to know how the heart works.

The heart is about the size of a closed fist. It delivers blood to the lungs and to all the body tissues. The heart has four chambers. The right atrium receives blood from the body and pumps it to the right ventricle. The right ventricle then pumps blood to the lungs where it picks up oxygen. The left atrium receives oxygen-rich blood from the lungs and sends it to the left ventricle. From there it pumps blood to the body.

VAD Placement
During surgery, an LVAD (left ventricular assist device) is connected to the left ventricle and aorta. It receives oxygen-rich blood from the left ventricle and pumps blood into the aorta. From there, blood is sent to the rest of the body.

The VAD is connected to an outside control device and a power source. During the day, the VAD is powered by portable batteries, so that patients can move about freely. At night time, the VAD is powered by a machine that is plugged into an electrical outlet at home.

Recovery
Most patients who receive a VAD have a two week hospital stay. This allows patients to:

• Gain strength
• Increase activity level
• Learn how to take care of new mechanical pump

At home, patients can return to most of their usual activities, including work.

A VAD helps the failing ventricle pump blood. Either one or both ventricles can be assisted. VADs are used most often to increase the function and survival of patients:

• Waiting for a heart transplant. This is known as Bridge to Transplant Therapy.
• With end-stage heart failure who are not transplant candidates. This is known as Destination Therapy.

Patients that receive VADs can often leave the hospital and return to work

There are several types of VADs. The most common VAD is connected to the left ventricle and the aorta. It pulls oxygen-rich blood out of the ventricle and pumps it to the aorta and the rest of the body. The VAD is placed in the abdomen during surgery. It is connected to an outside control device and power source. A portable battery pack allows the patient to move about freely.