Frequently Asked Questions about VAD

Answers for patients to frequently asked questions about ventricular assist devices (VAD):

What is heart failure?

What is a ventricular assist device (VAD)?

How is a VAD implanted?

What is it like to live with a VAD?

What support would I have?

How do I know if I would benefit from a VAD?

Are there other options for my condition?

What is heart failure?
Heart failure (HF) is a condition in which the heart is too weak to pump enough blood to meet your body's needs. HF is usually a chronic condition that can be effectively managed, even reversed, with proper medication, lifestyle changes, and occassionally, medical devices. HF has many causes, including previous heart attack. A specific cause is often not discovered.

What is a ventricular assist device (VAD)?

HeartMate II
Reprinted with the permission of Thoratec Corporation
A VAD is a mechanical heart pump that is surgically implanted in the body. The device helps a weak heart by pumping blood for the heart. See how a VAD works. A tiny spinning rotor within the device drains blood from the heart and pumps the blood into the major artery of the body (the aorta). Although the pump is within the body, a thin tube (or driveline) exits the skin over the abdomen to connect the internal pump to an external controller.

The VAD is implanted through an incision through your sternum (breast bone). A driveline, a tube that contains the electrical wire to run the pump, comes out of the skin on the left side of your abdomen. The pump is attached to your heart and takes the blood into the device and pumps it to the body through another tube attached to your aorta, the large artery leaving your heart. The VAD is powered by either batteries of wall power.

The VAD has four main parts:

HeartMate II
Reprinted with the permission of Thoratec Corporation
  • The implanted blood pump
  • A tube that passes out of your body on the left side of your abdomen (driveline)
  • A small computer (controller) that controls the pump’s operation.
  • The external power source, which is either two batteries that last ten hours or the power module that plugs directly into standard wall power.

How is a VAD implanted?
Surgery to implant a VAD is similar to other forms of open-heart surgery and requires the opening of the chest and upper abdomen and use of a heart-lung bypass machine. Once the chest has been surgically opened, one end of the VAD is sewn into the tip of the heart, and the other end is sewn into the aorta. The driveline is tunneled under the abdomen and exits the skin.

Occassionally, other types of heart surgery (bypass surgery, valve surgery) are performed at the same time as the VAD is implanted. Surgery usually takes six to ten hours. After the surgery, patients recover in the intensive care unit for several days.

 

What is it like to live with a VAD?
Most patients who undergo VAD surgery feel dramatically improved once they have recovered from surgery (several weeks) and are able to enjoy an active lifestyle. Many patients find that they are able to enjoy activities they had not experienced in years. Although some adjustments are needed, patients can maintain physical intimacy with a partner, travel and enage in non-contact sports like golf.

Having a VAD does require continued use of medications, including blood thinners; close follow-up with the medical care team; and care of the driveline exit site to prevent infection. Patients with a VAD are required to carry equipment at all times: extra batteries, extra controller and a cell phone. These items can all fit into a convenient travel case. You must be tethered either to the batteries or the power module at all times.

Patients with a VAD can shower using a special kit to prevent water from damaging the device components, but immersion in water, such as bathing or swimming, is not safe. In addition, VAD patients are encouraged not to drive.

This all sounds overwhelming. What support would I have?

HeartMate II
Reprinted with the permission of Thoratec Corporation

The VAD team will train you or your caregiver to change the dressing and manage the device and power supply. You or your caregiver will also be taught what to do in an emergency, including changing the controller. You will be able to be alone at home after your have recovered from the procedure and can demonstrate adequate knowledge of the procedures. Otherwise, we will require you to have a caregiver (such as a family member) with you at all times in case of an emergency.

There will be a member of the team available for you at all times by cell phone to answer questions and advise you in case of an emergency.

How do I know if I would benefit from a VAD?
There are many potential treatments for heart failure. It is important that you receive personalized recommendations to ensure you receive the right treatment for your particular circumstances. Always consult with your physician. Additional information for medical professionals can be found here. Or, ask your doctor to consider referring you for a consultation with a Providence heart failure specialist.

Are there other options for my condition?
There are a number of other treatments for heart failure including oral and IV medications and heart transplantation. Our goal is help identify the best treatment for you, based upon your condition and your goals.