A heart assist system implantation is an artificial heart. It is also called a ventricular assist device (VAD). This single-chamber artificial heart works by compressed air or battery power. The device boosts the function of a failing heart ventricle.
Left Ventricular Assist Device
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Heart failure occurs when the heart is too weak to pump all the blood it receives and blood begins to back up. Blood can back up into the lungs and into the lower parts of the body. This can cause trouble breathing, cough, and swelling of the legs and ankles.
Getting a VAD is a way to improve the heart's ability to pump without having a
heart transplant. A VAD is sometimes referred to as a bridge to transplant, since it can be used while a person is waiting for a
heart transplant. This device can also be used for permanent treatment in people who:
Are not candidates for transplantDo not respond to standard treatmentHave a low risk of surviving 1 year
If you are planning to have VAD implantation, your doctor will review a list of possible complications, which may include: BleedingBlood clotsInfectionDevice failureAdverse reaction to the anesthesiaKidney, lung, or heart damage
Factors that may increase the risk of complications include: A serious infectious diseaseAdvanced disease of vital organs other than the heartBlood clotting disorderExcessive alcohol consumptionSmoking
Also, if you have a small stature, you may not be able to get a VAD due to the size of the device.
Be sure to discuss these risks with your doctor before the surgery.
If you need a VAD, it is because your heart is failing. Most likely, you will be on a list to receive a heart transplant. You may already be in the hospital. Your doctor will do many tests, including: X-rayEchocardiogram—size, shape, and motion of the heart are examined
Cardiac Catheterization—to look for
coronary artery diseasePsychological and social system evaluations to make sure you are prepared to manage the device outside of the hospital
Leading up to the procedure, your doctor will instruct you to: Avoid eating for 8 hours before the procedure
certain medications for 1 week before surgery.
will be used. It will block any pain and keep you asleep through the surgery.
This procedure involves open heart surgery. An incision will be made down the length of your breast bone. The breast bone will then be split and separated. You will be placed on a heart-lung machine. This machine will take the place of your heart and lungs during the surgery. The VAD will be placed into a pocket on the inside of the abdominal wall. Tubes will be sewn
to your heart. Tubes may also be sewn
to your aorta, depending on the type of device.
You will be in the intensive care unit (ICU) after the procedure. You will be connected to many tubes. The medical staff will monitor you.
You will have pain from the surgery. Ask your doctor about medications to help with the pain.
2-5 days in the ICU2-4 weeks in a regular hospital room
When you return home, do the following to help ensure a smooth recovery: Stay in contact with the heart center. You may be waiting for a heart transplant.
Be sure to follow your doctor’s instructions. Instructions will include:
How to take care of your VADWhen to contact the hospital—Make sure that you know how to call your doctor if you have an emergency.
After you leave the hospital, contact your doctor if any of the following occur: Signs of infection, including fever and chillsRedness, swelling, excessive bleeding, or any discharge from the incision siteIncreasing painOne-sided weakness, blurry vision, or inability to talkA cold, pale or blue, numb, or painful extremityCough, difficulty breathing, or chest painNausea, vomitingProblems with urination or bowel movementsRedness or swelling in legs.Warning indications from the device
In case of an emergency, call for emergency medical services right away.
The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) trial.
NEJM. 2001 Volume345:1435-1443
Slaughter M, Milano C, et al. Advanced heart failure treated with continuous-flow ventricular assist device.
N Engl J Med. 2009; DOI:101056/NEJMoa0909938.
Ventricular assist devices (VAD). Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/heart/disorders/heartfailure/lvad_devices.aspx. Updated February 2015. Accessed June 9, 2016.
3/6/2013 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Peura JL, Colvin-Adams M, Francis GS, et al. Recommendations for the use of mechanical circulatory support: device strategies and patient selection: a scientific statement from the American Heart Association.
Last reviewed June 2016 by Michael J. Fucci, DO, FACC
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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