Ventricular assist device
Ventricular assist devices (VAD) are a mechanical circulatory support device, which is providing an effective therapy for a significant number of patients with advanced heart failure. There are mostly left VADs, although right VADs are also implanted.
Device elements
- inflow cannulas
- electrically supplied pump
- outflow cannula
- driveline
- external controller
The patient’s cardiac function and the speed settings of the VAD determine the amount of blood flow that is pumped by this device.
Indications
- bridge to transplant: VADs have considerably improved the care of patients awaiting heart transplantation
- destination therapy: patients implanted as “destination therapy” will remain on the VAD for the rest of their lives
- bridge to recovery: temporary VAD provides support for a few days or weeks
Complications
- perioperative hemorrhage
- air embolism
- right ventricular failure after left VAD implantation
- infection
- thromboembolism
- device malfunction/failure
- pump thrombosis
- stroke
- dysrhythmia
- aortic regurgitation
Treatment and prognosis
As long as patient use this device, LVAD function, patient perfusion, and mean arterial pressure are being assessed and anticoagulation (warfarin) and antiplatelet therapy have to be used.
