Temporary ventricular assist devices
Temporary ventricular assist devices (or temporary VADs) are temporary percutaneous devices used in supporting a failing heart in cardiogenic shock or perioperatively.
Temporary VADs consist of an inlet, outlet and impeller pump all housed within a catheter. Temporary VADs are inserted percutaneously usually via the femoral artery. They are advanced retrograde until they overlie the aortic valve and project into the left ventricle. Blood is pumped from the left ventricle through the inlet via the impeller pump and then out into the aorta via the outlet. They usually remain in situ for 4-6 days . The most common type is the Impella family of devices.
The tip of a left-sided temporary VAD should be located centrally over the left ventricle .
Complications that may arise from temporary VAD insertion and use include :
- cardiac arrhythmias
- ventricular perforation
- aortic wall injury
- pump thrombosis
- device failure
- device fracture
Impella devices are unsafe with MRI .