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What Is a Ventricular Assist Device?

A ventricular assist device (VAD) is a mechanical pump that’s used to support heart function and blood flow in people who have weakened hearts.
The device takes blood from a lower chamber of the heart and helps pump it to the body and vital organs, just as a healthy heart would. (For more information about how the heart pumps blood, go to the Health Topics How the Heart Works article.)
You may benefit from a VAD if one or both of your ventricles (VEN-trih-kuls) don’t work well because of heart disease. Ventricles are the lower chambers of your heart.

A VAD can help support your heart:

  • During or after surgery, until your heart recovers.
  • While you’re waiting for a heart transplant.
  • If you’re not eligible for a heart transplant. (A VAD can be a long-term solution to help your heart work better.)

A VAD has several basic parts. A small tube carries blood out of your heart into a pump. Another tube carries blood from the pump to your blood vessels, which deliver the blood to your body.
A VAD also has a power source that connects to a control unit. This unit monitors the VAD’s functions. It gives warnings, or alarms, if the power is low or the device isn’t working well.
Some VADs pump blood like the heart does, with a pumping action. Other VADs keep up a continuous flow of blood. With a continuous flow VAD, you might not have a normal pulse, but your body is getting the blood it needs.
from the pump to your blood vessels, which deliver the blood to your body.
A VAD also has a power source that connects to a control unit. This unit monitors the VAD’s functions. It gives warnings, or alarms, if the power is low or the device isn’t working well.
Some VADs pump blood like the heart does, with a pumping action. Other VADs keep up a continuous flow of blood. With a continuous flow VAD, you might not have a normal pulse, but your body is getting the blood it needs.
Research has shown that, compared with other VADs, continuous flow VADs may decrease hospital stays and complications and improve survival. However, more research is needed.

Types of Ventricular Assist Devices

The two basic types of VADs are a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD). If both types are used at the same time, they’re called a biventricular assist device (BIVAD).
The LVAD is the most common type of VAD. It helps the left ventricle pump blood to the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body.
RVADs usually are used only for short-term support of the right ventricle after LVAD surgery or other heart surgery. An RVAD helps the right ventricle pump blood to the pulmonary (PULL-mun-ary) artery. This is the artery that carries blood from the heart to the lungs to pick up oxygen.

A BIVAD might be used if both ventricles don’t work well enough to meet the body’s needs. Another treatment option for this condition is a total artificial heart (TAH). A TAH is a device that replaces the ventricles.
VADs have two basic designs. A transcutaneous (tranz-ku-TA-ne-us) VAD has its pump and power source located outside of the body. Tubes connect the pump to the heart through small holes in the abdomen. This type of VAD might be used for short-term support during or after surgery.
An implantable VAD has its pump located inside of the body and its power source located outside of the body. A cable connects the pump to the power source through a small hole in the abdomen.

Implantable VADs are used mainly for people who are waiting for heart transplants or as a long-term solution for people who can’t have heart transplants.

Who needs VAD?

You may benefit from a ventricular assist device (VAD) if your heart doesn’t work well because of heart disease. Heart disease can prevent your heart from pumping enough blood to your body.

A VAD can help support your heart:

  • During or after surgery, until your heart recovers.
  • While you’re waiting for a heart transplant.
  • If you’re not eligible for a heart transplant. (A VAD can be a long-term solution to help your heart work better.)
Short-Term Ventricular Assist Devices

A VAD can support heart function and blood flow for a short time before, during, and/or after heart surgery until your heart recovers. Your doctor may recommend a short-term VAD if you have a severe heart condition, such as heart failure, a ventricular arrhythmia, or cardiogenic shock.
You also might use a VAD if you have heart failure and your doctors need more time to plan your treatment.


Long-Term Ventricular Assist Devices

If you have heart failure and are waiting for a heart transplant, your doctor may recommend a VAD. If heart failure medicines aren’t working well, a VAD can keep you alive and improve your quality of life while you wait for a donor heart.
If you’re not eligible for a heart transplant, a VAD might be a long-term treatment option. It can improve your quality of life and allow you to do many daily activities.

When Are Ventricular Assist Devices Not Recommended?

VADs might not be a treatment option for people who have certain serious health conditions. Examples of these conditions include severe kidney failure, serious brain injuries, severe infections, and other life-threatening conditions.

What are the risks of the VAD implantation procedure?

As with any surgical procedure, there are risks to the VAD implantation procedure. Your doctor will talk with you about the specific risks and potential benefits of this procedure. Some of the possible risks include bleeding, development of blood clots, respiratory failure, kidney failure, stroke, infection and device failure. Special precautions are taken to decrease these risks.
There may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand why the procedure is recommended and the potential risks of the procedure.

How long can I be supported with a VAD?

The amount of time you can receive support from a VAD is variable, depending on the type of system you receive, whether the VAD was implanted for bridge-to-transplant or destination therapy, and your medical condition.
The average support duration for bridge-to-transplant applications varies, since the time needed to wait for transplant varies.

VAD and Surgery

A ventricular assist device has three parts:

  • A pump. The pump weighs 1 to 2 pounds. It is placed inside or outside of your belly.
  • An electronic controller. The controller is like a small computer that controls how the pump works.
  • Batteries. The batteries are carried outside your body. They are connected to the pump with a cable that goes into your belly

You will need general anesthesia when your VAD is implanted. This will make you unconscious and unable to feel pain during the procedure.
During surgery to implant the pump, the heart surgeon opens the middle of your chest with a surgical cut and then separates your breastbone. This allows the surgeon to reach your heart. Next, the surgeon will make space for the pump under your skin and tissue in the upper part of your belly wall. Then, the surgeon will place the pump in this space.
A tube will connect the pump to your heart. Another tube will connect the pump to your aorta or one of your other major arteries. Another tube will be passed through your skin to connect the pump to the controller and batteries.
The VAD will take blood from your left ventricle through the tube that leads to the pump. Then the device will pump the blood back out to one of your arteries and through your body.