Ventricular Assist Devices (VAD) For Heart Failure
May 22, 2013 Health

What is a ventricular assist device?

Ventricular assist device is a mechanical device that is implanted in the chest to assist with pumping of blood from the lower chambers of the heart (ventricles). These devices are implanted in people with a weak heart. It is placed in the right, left or both ventricles but most commonly the device is placed in the left side of the heart. It this side of the heart that has the most amount of work to do since it pushes blood throughout the body.

Ventricular Assist Device

Ventricular assist devices are recommended for patients who are waiting for a heart transplant or for the heart to become strong enough to be able to pump blood on its own. It is therefore often used as a short term option. In patients who are  are suffering from a severe degree of heart failure and are not suitable candidates for a heart transplant, a ventricular assist device is considered as a long term treatment option.

Reasons for a using a ventricular assist device

Ventricular assist devices support the ventricular function of the heart. The ventricles push blood out of the heart. Depending upon the site of implantation, it may help to assist the heart with pushing the blood to the lungs (right side), to the entire body (left side) or sometimes it may be used in both ventricles (biventricular).

Usually ventricular assist devices are recommended for a number of heart-related conditions such as:

  • People waiting for heart transplant where the ventricular assisted device can be implanted temporarily to aid with normal cardiac function until a donor heart becomes available. Once a donor heart is available and it is successfully implanted in the patient’s body the ventricular assist device may be removed. Implantation of the devices for this purpose is known as “bridge to transplant”.
  • In patients suffering from temporary heart failure a ventricular assist device may be recommended until the patient’s heart regains normal cardiac function. Sometimes after certain types of heart surgery the device can be implanted to support cardiac function until the patient recovers.
  • Ventricular assist devices are recommended as long treatment option in patients who are not suitable for heart transplant surgery. The device when used for long term in these cases is known as “destination therapy”.

In patients who cannot be helped with a ventricular assist device, another device known as total artificial heart (TAH) can be used. This device  replaces the function of the two ventricles of the heart. However, implanting this device is difficult and there may be certain complications with the use of a total artificial heart.

Preparation And Surgical Procedure

Before undergoing the implantation surgery the patient is required to stay in the hospital for the preparation of the oncoming surgery. Certain tests are advised namely echocardiogram, chest X-ray, electrocardiogram, cardiac catheterization as well as certain blood tests. The patient is also educated about the device and its safety precautions as well as life with the device.

The implantation of the device is done through open heart surgery. Usually it takes 4 to 6 hours for completion of the surgery. The patient is connected to a ventilator to assist breathing. The chest cavity is opened and the implantation of the device is carried out on the heart that is stopped from beating. The patient is connected to a heart lung bypass machine to facilitate oxygen supply during the surgery. The device is then implanted and after it can operate satisfactorily, the heart lung bypass machine is removed. The patient is monitored for a few days following surgery first in the ICU then in regular hospital room. Rare but serious complications include a post-operative infection, bleeding and heart failure.

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