Assist Devices

A ventricular assist device (VAD) is an implantable mechanical pump that helps pump blood from the lower chambers of your heart (the ventricles) to the rest of your body. A VAD is used in people who have weakened hearts or heart failure.

Although a VAD can be placed in the left, right, or both ventricles of the heart, it is most commonly used in the left ventricle. When placed in the left ventricle, it is called a left ventricular assist device (LVAD). Reasons why you may have a VAD implanted include:

• You are waiting for a heart transplant
• You are waiting for your heart to become strong enough to effectively pump blood on its own or you are waiting for your heart to function normally again after surgery
• If you have heart failure and you’re not a good candidate for a heart transplant, your doctor may recommend a VAD implant as an alternative, long-term treatment

The procedure to implant a VAD requires open-heart surgery and has serious risks. However, it can save your life if you have severe heart failure. Your doctor may review several factors and ask you a number of questions before deciding if a VAD is the most appropriate treatment for your condition.

BEFORE THE PROCEDURE

Before surgery to have a ventricular assist device implanted, your doctor and treatment team will explain to you what to expect before, during, and after the surgery. Potential risks and any concerns you may have will also be discussed.

Your doctor will also evaluate your current health/condition and ensure that you’re healthy enough for surgery to implant a VAD. Your doctor may order several tests including an echocardiogram, chest x-rays, blood tests, electrocardiogram (ECG), and cardiac catheterization.

DURING THE PROCEDURE

A team of heart surgeons, surgical nurse, and anesthesiologists will work to perform your surgery. Implanting a VAD requires open-heart surgery and the procedure generally takes four to six hours. You will be sleeping during the procedure and connected to a ventilator that will help you breathe. You may need to remain on this ventilator for several days after the surgery.

A surgeon will make an incision down the center of your chest and will separate your chest bone and open your rib cage so that he or she can operate on your heart. Your heart may be stopped using medications during the surgery, but you will be connected to a heart-lung bypass machine that keeps oxygenated blood flowing through your body during surgery. The surgical team will implant the VAD during surgery. After your VAD is implanted and working properly, you will be taken off of the heart-lung bypass machine so that the VAD can begin pumping blood through your heart.

AFTER THE PROCEDURE

After surgery to implant a VAD, you’ll stay in the intensive care unit (ICU). You’ll be given fluids, nutrition, and medications to IV lines. Other tubes will drain urine from your bladder.

Your lungs may not work properly immediately after your surgery, so you may need to remain connected to a ventilator for a few days after surgery until you’re able to breathe on your own. You will likely be given blood-thinning medications to prevent blood clots and other antibiotics to prevent infections. It is very important that you take these as instructed.

After a few days in the ICU, you’ll be moved to a regular hospital room. The amount of time you’ll spend in the ICU and in the hospital depends on your condition before the procedure and how well you are recovering. Your treatment team will work with you to help you gain strength and prepare for going home.

For the first month after your procedure, you’ll likely have regular follow up appointments with your doctor and other members of your treatment team.