What is VAD?

Publication Date:
Fri, 04/01/2016
By: Alere Staff

A ventricular assist device, or VAD, is a pump that is surgically implanted into the chest to assist a weakened heart in pumping oxygen-rich blood to the body.1 These devices are primarily used to treat advanced stages of heart failure. Heart failure is a condition which affects over 5 million people in the United States.2 When a person has heart failure, the heart cannot pump enough blood to meet the body’s needs. It does not mean the heart has stopped working or is about to stop working. The heart is just not able to do its job effectively. This can lead to symptoms of weakness, fatigue, unexplained weight gain and shortness of breath. Advanced stages of heart failure can also lead to additional symptoms of loss of appetite, nausea/vomiting, abdominal swelling, swelling of the legs or arms, cough, and difficulty sleeping. Patients with advance heart failure are unable to complete even the smallest of tasks, like dressing, walking and shopping, without a sense of exhaustion.2,3

When a VAD is Needed

Heart failure is a progressive condition which can worsen over time. In the early stages, heart failure is generally managed with medications prescribed by your doctor along with lifestyle changes such as reducing salt intake, increasing exercise and monitoring weight every day. In more advanced stages, these conservative measures are no longer effective in preventing symptoms. Your doctor may discuss the treatment option of heart transplant or VAD.2,4

A VAD works with the heart to increase the amount of blood being pumped to the body. The most common type of VAD is called an LVAD or Left Ventricular Assist Device. This type of VAD is inserted near or into the left ventricle of the heart, which is the part of the heart that pumps oxygen-rich blood to your entire body.4   

The VAD has several components that can be either internal or external. Internal components are inserted into the body and external components remain on the outside of the body. The internal components include the pump and the tube that directs blood from the pump to the aorta or large blood vessel that distributes blood from the heart to the rest of the body. The external components are attached to the pump by a driveline that exits the body through the abdominal wall. The external components include the power source (battery or electric) and the controller which is used to regulate and monitor the pump function.4

A VAD is implanted during an open heart surgery which can take four to six hours. Prior to surgery you will have screening tests and will meet the VAD team of specialists who will support you through the whole process.  Recovery from surgery could take two to four weeks in the hospital. During this time, the VAD team of specialists (the surgeon, VAD coordinator, nurses, physical therapists, occupational therapists and social workers) work with both you and your family to assist with the transition to home. You will need to learn how to care for the yourself and your equipment in everyday life circumstances.4,5

Life with a VAD

There are risks involved with VAD implantation. Since the device is “foreign” to the body, the body could form blood clots inside the device that would affect the flow of blood through the device. You may be prescribed anticlotting medications to prevent blood clots. Bleeding is another concern and is often complicated by the use of the anticlotting medications. Your VAD team will monitor you closely for any side effects of bleeding. There is a risk of infection after surgery as well since VAD implantation includes parts that connect from the outside of the body to the inside of the body. You will be taught how to look for signs of infection that should be reported to your VAD team immediately.4,5

VAD implantation is a big adjustment for you and your family, both physically and emotionally. However, thousands of patients worldwide are living productive lives with their VAD.  Most patients return to living at home, moving about freely, enjoying favorite activities, resuming sexual activity, exercising, returning to work or school and driving.  Patients will have noticeably more energy for daily activities because their heart is pumping more effectively.4,5

Heart failure is a progressive and often debilitating condition. When prescribed medications and lifestyle changes fail to improve symptoms and overall heart function continues to decline, your doctor may recommend VAD as an option for treatment. With ever-changing technology, these devices are becoming smaller and more efficient. In many cases, life expectancy is increased and quality of life is improved.4,5

References:

  1. Cowley, G. et al. Medical Definition of VAD. Newsweek, 25 June 2001. Retrieved from the website: www.merriam-webster.com/medical/vad.
  2. U.S. Department of Health and Human Services. How is Heart Failure Treated? National Heart, Lung and Blood Institute. 6 November 2015. Retrieved from the website:http://www.nhlbi.nih.gov/health/health-topics/topics/hf/treatment.  
  3. About Heart Failure. American Heart Association. 2016. Retrieved from the website:http://www.heart.org/HEARTORG/Conditions/HeartFailure/HeartFailure_UCM_002019_SubHomePage.jsp
  4. Mayo Foundation for Medical Education and Research. Left Ventricular Assist Device (LVAD).Mayo Clinic. 2016. Retrieved from the website: http://www.mayoclinic.org/tests-procedures/ventricular-assist-devices/multimedia/left-ventricular-assist-device-lvad/img-20006714.  
  5. U.S. Department of Health and Human Services. What is a Ventricular Assist Device? National Heart, Lung and Blood Institute. 31 March 2012. Retrieved from the website:http://www.nhlbi.nih.gov/health/health-topics/topics/vad/.