A VAD, or ventricular assist device, is a mechanical heart pump that can be implanted alongside a weakened heart to help it pump blood throughout the body. The device does not replace the heart, but helps it pump blood more effectively.
VADs most commonly are placed to assist the left side of the heart, which is responsible for sending oxygen-rich blood out to the body. In this use, a left-ventricle assist device (LVAD) takes the workload off the left ventricle after heart failure has significantly decreased its pumping power.
The Norton Heart & Vascular Institute Mechanical Circulatory Support Program offers the latest in VAD technology to support a patient’s heart when medication can’t effectively control heart failure symptoms. A VAD also can be implanted to sustain a patient while awaiting a heart transplant.
What Is an LVAD and How Is It Different From a VAD?
Most heart failure happens on the left side of the heart and, specifically, in the left ventricle. An LVAD is a type of VAD that supports the left ventricle. Less frequently, a VAD can be placed on the right side of the heart to support the right ventricle or configured to support both ventricles.
This is the part of the heart muscle that squeezes oxygen-rich blood out to the body. When the heart fails to pump blood as it should, it is often because the left ventricle muscle has thickened and enlarged after years of high blood pressure.
The thicker muscle is less efficient at pumping blood. As heart failure progresses, patients become less able to tolerate exertion and are short of breath even while lying down. As the heart is less able to keep blood moving, fluids can back up in the body, causing congestion in the lungs and other organs (congestive heart failure).
Depending on your condition and your treatment goals, you may qualify for an LVAD. With the mechanical heart pump in place, many patients are able to resume activities and won’t need a heart transplant. In some patients, a VAD is used as a bridge to a heart transplant.
Do I Need a VAD?
If your heart failure symptoms cannot be controlled by medications alone, it is time to consider alternative therapy. Some individuals may need a heart transplant, and a VAD can provide short-term relief while they await their surgery. For others, a VAD can be a long-term treatment.
As a bridge to transplant, a VAD can help a person survive until a donor heart becomes available. The VAD may allow you to go home while waiting for a heart transplant.
A VAD also can be used as destination therapy, a more permanent solution, which is an alternative to a heart transplant. As a destination therapy, it can be used if you are not a candidate for a transplant.
Whichever use is determined to be best for you, the goal of having a VAD placed is to provide effective support for your heart and maintain or improve your heart function.
How a VAD Is Implanted
The VAD itself is implanted and connected to your heart and blood vessels. A wire leads from inside your chest to a controller and battery packs on a belt.
During surgery to implant your VAD, our surgeons will connect your arteries and veins to a heart-lung bypass machine. The pump itself will be in your upper abdomen with tubes connecting it to your heart and an artery.