Ventricular assist device (VAD) for heart failure
A ventricular assist device (VAD) is a mechanical pump that helps pump blood from the heart to the rest of your body. See an illustration of a VAD
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A VAD is surgically implanted in the chest and abdomen through an incision in your breastbone. The pump part of the VAD is placed in a small space in your upper abdomen. Batteries that power the pump are usually worn on a belt or pouch outside your body. After the VAD has been implanted, your doctor will make another small incision in your side to connect the electrical wires that power the device.
If you are getting a VAD to assist the pumping of the left side of your heart (LVAD), your doctors will attach the tube flowing into the VAD to your left ventricle. Your doctor will then attach the other tube to your aorta. If you are getting a right-sided VAD (RVAD), the tubes will be attached into your right ventricle and pulmonary artery. LVADs are used much more commonly than RVADs.
How does it work?
A VAD helps pump blood when the heart is not able to pump enough blood on its own. It removes blood from your heart and pumps it to the rest of your body. This way, most of the blood that your heart would normally pump is pumped by the VAD instead. Most VADs have an automatic mode that adjusts to different levels of activity. For example, if you begin to walk or jog, your VAD can increase how much blood it pumps.
What are the drawbacks?
People with VADs may have complications, such as excessive bleeding, infection, device malfunction, and blood clotting. However, these problems do not happen very often because of recent advances in VAD technology.
How long will it keep me alive?
In a recent study, 10 people with severe heart failure who had also been approved for heart transplant received VADs. Of the 10, 7 received heart transplants within an average of 84 days. During the time they waited for heart transplants and were supported by the VAD (which ranged from 13 to 214 days), they were able to leave the hospital and return to their normal activities.1
At this time, VADs offer a way of keeping you alive until a donated heart is available. However, some heart specialists are now seriously considering using VADs for long-term treatment in addition to using them as a bridge to heart transplants. As newer, better VADs are designed, there is potential for even better long-term success.
A recent study of 129 people with end-stage heart failure demonstrated their potential for long-term use. Of these people, who were not candidates for heart transplants, 68 received a VAD, and 61 were given medicine therapy. The people in the group who received VADs lived longer (52% survived after 1 year versus 25%) with a significant improvement in their quality of life compared with the medical therapy group.2
| Author: | Robin Parks, MS | Last Updated: September 1, 2006 |
| Medical Review: | Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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