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Why it's done
By Mayo Clinic staff
VADs are mechanical devices that support the lower left heart chamber (left ventricular assist devices, or LVADs), the lower right heart chamber (right ventricular assist devices, or RVADs) or both lower heart chambers (biventricular assist devices, or BIVADs).
Your doctor may recommend you have a VAD implanted if:
- You're waiting for a heart transplant. You may have a VAD implanted temporarily while you wait for a donor heart to become available. A VAD can keep blood pumping despite a diseased heart and will be removed when your new heart is implanted. When a VAD is implanted while you're waiting for a heart transplant, it's referred to as a "bridge to transplant."
- Your heart's function can become normal again. If your heart failure is temporary, your doctor may recommend implanting a VAD until your heart is healthy enough to pump blood on its own again. It's also possible you'll have a VAD implanted for a short time if you're recovering from heart surgery. You may have a VAD implanted for only a few weeks or months. RVADs are often temporarily implanted after some heart surgeries. An RVAD can help keep blood flowing from the right ventricle to your lungs.
- You're not a good candidate for a heart transplant. VADs are increasingly being used as a long-term treatment for people who have heart failure, but aren't good candidates for a heart transplant. A VAD can improve your quality of life. When a VAD is implanted as a permanent treatment for heart failure, it's referred to as destination therapy.
If VADs can't help your heart, another treatment option your doctor may consider is a total artificial heart (TAH). This device replaces the two ventricles of your heart. Because a total artificial heart is difficult to implant and can cause serious complications, it's only used in a small number of people.
References
- Heart failure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hf/. Accessed Feb. 2, 2012.
- Jessup M, et al. 2009 focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults. Circulation. 2009;119:1977.
- Ventricular assist device. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/vad/vad_all.html. Accessed Feb. 2, 2012.
- Slaughter MS, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. New England Journal of Medicine. 2009;361:1.
- Mancini D, et al. Mechanical device-based methods of managing and treating heart failure. Circulation. 2005;112:438.
- Anscheim DD, et al. Innovation with experience using implantable left ventricular assist devices. Circulation: Heart Failure. 2009;2:1.
- Heart transplant. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/ht/ Accessed Feb. 2, 2012.
- Total artificial heart. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/tah/. Accessed Feb. 2, 2012.
- Mitter N, et al. Update on ventricular assist devices. Current Opinion in Anaesthesiology. 2010;23:57.
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