Heart Assist System Implantation
(Ventricular Assist Device; VAD)
by Ricker Polsdorfer, MD
A heart assist system implantation is an artificial heart. It is also called a ventricular assist device (VAD). This single-chamber artificial heart works by compressed air or battery power. The device boosts the function of a failing heart ventricle.
Reasons for Procedure TOP
Heart failure occurs when the heart is too weak to pump all the blood it receives and blood begins to back up. Blood can back up into the lungs and into the lower parts of the body. This can cause trouble breathing, cough, and swelling of the legs and ankles.
Getting a VAD is a way to improve the heart's ability to pump without having a heart transplant. A VAD is sometimes referred to as a bridge to transplant, since it can be used while a person is waiting for a heart transplant. This device can also be used for permanent treatment in people who:
Possible Complications TOP
If you are planning to have VAD implantation, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
Also, if you have a small stature, you may not be able to get a VAD due to the size of the device.
Be sure to discuss these risks with your doctor before the surgery.
What to Expect TOP
Prior to Procedure
If you need a VAD, it is because your heart is failing. Most likely, you will be on a list to receive a heart transplant. You may already be in the hospital. Your doctor will do many tests, including:
Leading up to the procedure, your doctor will instruct you to:
General anesthesia will be used. It will block any pain and keep you asleep through the surgery.
Description of the Procedure TOP
This procedure involves open heart surgery. The doctor will make an incision down the length of your breast bone. The breast bone will then be split and separated. You will be placed on a heart-lung machine. This machine will take the place of your heart and lungs during the surgery. The doctor will place the VAD into a pocket on the inside of the abdominal wall. Tubes will be sewn to your heart. Tubes may also be sewn to your aorta, depending on the type of device.
Immediately After Procedure TOP
You will be in the intensive care unit (ICU) after the procedure. You will be connected to many tubes. The medical staff will monitor you.
How Long Will It Take? TOP
About 4-8 hours
How Much Will It Hurt? TOP
You will have pain from the surgery. Ask your doctor about medications to help with the pain.
Average Hospital Stay TOP
Postoperative Care TOP
When you return home, do the following to help ensure a smooth recovery:
Ask your doctor about when it is safe to shower, bathe, or soak in water.
Call Your Doctor TOP
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
American Heart Association
United States Food and Drug Administration
Heart and Stroke Foundation of Canada
The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) trial. NEJM. 2001 Volume345:1435-1443
Slaughter M, Milano C, et al. Advanced heart failure treated with continuous-flow ventricular assist device. N Engl J Med. 2009; DOI:101056/NEJMoa0909938.
Ventricular assist devices (VAD). Cleveland Clinic website. Available at:
...(Click grey area to select URL)
Updated December 2009. Accessed August 9, 2013.
3/6/2013 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Peura JL, Colvin-Adams M, Francis GS, et al. Recommendations for the use of mechanical circulatory support: device strategies and patient selection: a scientific statement from the American Heart Association. Circulation. 2012;126(22):2648-2667.
Last reviewed August 2013 by Michael J. Fucci, DO; Michael Woods, MD
Last Updated: 5/11/2013