The Case for VADs
Since there are not enough donor hearts to meet the needs of all the patients who require them, people with severe ("end-stage") heart failure may benefit from a VAD. VADs are often used as a "bridge to a transplant," allowing critically ill individuals to live productive lives at home while waiting for a heart donor. VADs can also be used as a "bridge to recovery" when a person's heart failure is temporary, while waiting for heart muscle to recover. Increasingly, VADs are being used as "destination therapy" in people who have heart failure, but who aren't candidates for a heart transplant. In these patients, VADs are placed permanently and have been shown to improve quality of life. Unlike the first generation of VADs from 15 years ago, today's devices are smaller, quieter, and more comfortable and have a longer battery life.
How a VAD Works
The left ventricle is the chamber responsible for pumping oxygen-rich blood from the heart to the aorta for transport to the rest of the body. Left ventricular assist devices (LVADs) take on the workload of the left ventricle, helping the heart to pump oxygenated blood to the rest of the body. As a result, all tissues and organs receive the blood supply they need to do their jobs. Some people need support of the right heart as well, which pumps blood to the lungs, where it can receive oxygen. Right ventricular assist devices (RVADs) are commonly used in conjunction with LVADs and are referred to as biventricular assist devices (or BiVADs). The VAD consists of:
- A pump. The pump is implanted in or near the upper part of the abdominal wall and is connected to the heart at two points. A tube carries blood from the ventricle to the pump. The blood is pumped through a second tube to the aorta or pulmonary artery, and distributed to the lungs or throughout the body.
- An electronic control system. A third tube extends from the pump and contains wires that connect the pump to the electronic control system.
- A power supply (rechargeable batteries). The control system is connected to small batteries. Patients wear the controller on a belt and the batteries on a vest-like shoulder holster.