ventricular assist devices

overview

A ventricular assist device (VAD) is a mechanical device that helps treat heart failure – when the heart is unable to pump enough blood to meet your body’s needs. 

The heart is a muscle with four chambers. It pumps blood by squeezing the two lower chambers, or ventricles. When the left ventricle squeezes, it forces blood into the aorta, which is the main artery that takes blood away from the heart to the major arteries of your body. When the right ventricle squeezes, it forces blood into your pulmonary artery, which supplies blood to your lungs. A VAD, implanted into a weakened heart, pulls blood from either the left or right ventricle and pumps it to either the aorta or the pulmonary artery. The VAD has a line that exits the body and is attached to a mini-computer called a controller. A VAD may be placed into the left ventricle of the heart (LVAD), the right ventricle of the heart (RVAD) or both ventricles (BiVAD).

evaluation

Medications are usually used first to treat heart failure symptoms, but if they don’t work or you can’t tolerate them, your doctor may recommend a ventricular assist device. Sometimes, a VAD is a temporary solution (bridge) while you wait for a heart transplant. Other times, it’s a long-term solution (destination therapy) if you’re not eligible for a heart transplant due to age or other conditions.

Before a VAD, you’ll have to have some cardiac and lab tests, a psychosocial evaluation and a dental exam. You may be admitted to the hospital for some of this testing. You’ll also meet with a clinical engineer so you can see how the VAD works.

what to expect

Getting a VAD placed is major cardiac surgery that takes several hours. You’ll be put under general anesthesia, have an incision along your breastbone and be put on a heart-lung bypass machine. You’ll have several IV (intravenous) lines, as well as tubes to drain urine. You’ll be on a breathing machine (ventilator).

recovery

After your surgery, you’ll be taken to the cardiovascular intensive care unit. Later, you’ll be transferred to a regular hospital room while we continue to monitor your heart rate, rhythm and VAD readings. While you stay in the hospital, you’ll get physical, occupational and cardiac-rehab therapy, and the clinical engineers will educate you and your family on VAD care, operation and troubleshooting. You’ll also learn how to care for the driveline site and incision, including how to shower with the device. If you need any supplies or equipment at home, we can arrange for that. You may have to take anticoagulation medications, such as Coumadin (warfarin) or aspirin, to prevent blood clots.  

A week after you’re home, you’ll come back to the Tendick Center for the Surgical Treatment of Heart Failure for a follow-up appointment. We also recommend that you sign up for a cardiac rehab program. 

The risks of a VAD implantation are similar to those of any major heart surgery. There are also other risks and complications specific to the VAD, such as infection, a malfunction of the pump, stroke, bleeding, blood clots and kidney, lung, liver or heart damage.

why Aurora?

Aurora St. Luke’s Medical Center is nationally recognized for its VAD program, which is the largest in Wisconsin. Our program has received disease-specific certification by the Joint Commission for destination therapy. We take a team approach to caring for patients, including advance practice nurses, cardiologists and surgeons, clinical engineers, dieticians, rehab therapists, psychologists and social workers.

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