Ventricular Assist Devices (VADs)

A ventricular assist device is a surgically implanted pump used to support heart function for patients with advanced heart failure. Depending on the patient's diagnosis, the VAD sustains the right or left ventricle. VADs "assist" the weakened part of the heart.

The HeartMate® II and HeartWare® are types of left ventricular assist devices (LVADs). They work by pulling blood from the left ventricle (the lower part of the heart) and pushing it out the aorta, the blood vessel that carries blood from the heart to the rest of the body.

We are also one of only five sites in the nation that are using the BrioVAD™, which offers a novel, smaller LVAD with a longer battery life for advanced heart failure patients, including non-transplant candidates and smaller patients.

The LVAD includes a pump implanted in the upper part of the abdomen or directly next to the heart that is attached to a flexible cable that runs outside of the body and connects to a power source.

Other types of VADs, such as the Thoratec® PVAD (paracorporeal ventricular assist device), can work in the left, right, or both sides of the heart simultaneously.

There are two types of VADs that can be inserted without open-heart surgery: the TandemHeart™ and the Impella®. Each of these devices is implanted through catheters that are placed in the groin, and they are designed for temporary use. They can be implanted while waiting for cardiac recovery after an acute event, while awaiting cardiac transplantation or as a bridge to one of the durable LVADs (Heartmate® II or Heartware®). Patients must remain hospitalized while these pumps are in place.

For patients with advanced heart failure who meet specific criteria, VADs may offer a viable treatment strategy. Typically, to be an eligible candidate, a patient must fall under either Class III or Class IV as set by the New York Heart Association classifications.

• Class III – Patients with cardiac disease resulting in significant limitation of physical activity. They are comfortable only at rest.
• Class IV – Patients with cardiac disease resulting in an inability to carry on any physical activity without discomfort. Symptoms of heart failure or angina may be present even at rest.

VADs are not an appropriate option for some patients with heart failure. People who might not be good candidates for VADs include those with irreversible kidney failure, liver disease, lung disease or blood clotting disorders.

VADs are an evolving medical technology. Newer models are smaller and longer lasting than those developed a decade ago.

However, implanting a VAD requires major surgery and hospitalization. Risks associated with the procedure include, bleeding, blood clots, stroke, infection and device malfunction.

Our expert team will discuss these risks with you and answer any questions you may have concerning the surgery.

After the procedure, you will remain in the hospital for approximately two weeks. Our medical team of physicians, surgeons and nurses will work together to monitor your progress and provide comprehensive care as you regain strength and adjust to navigating life with mechanical circulatory support.

The longevity of your VAD depends on the intended use of the device. For destination therapy patients, the VAD is meant to maintain heart functionality long term. For bridge-to-transplant patients, the device is designed to support the heart for a finite amount of time.

Most patients will return home usually two to three weeks after surgery. Some devices enable patients to be discharged after surgery, while others require inpatient care. With a VAD, you will need to be connected to a power source at all times. In addition, care must be taken to avoid damaging the equipment or interfering with the wiring.

Because some of the mechanical elements of the VAD are located outside of your body, you will not be able to shower conventionally. Additionally, your physical activities will be limited. For example, you cannot go swimming or engage in contact sports, or other activities that could disengage the power. However, many patients carry on daily activities and enjoy the greater measure of freedom VADs provide in their lives.