Carl R. Darnall Army Medical Center - Health Library

Heart Assist System Implantation

(Ventricular Assist Device; VAD)

Definition

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.

Left Ventricular Assist Device
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Reasons for Procedure ^

Heart failure happens when the heart is too weak to pump the blood the body needs. Blood starts to back up. It backs up into the lungs and lower parts of the body. This can cause breathing problems, coughing, as well as swelling in 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 as a permanent treatment in people who:

  • Aren't candidates for transplant
  • Don't respond to standard treatment
  • Have a low risk of surviving 1 year

Possible Complications ^

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Bleeding
  • Blood clots
  • Infection
  • Device failure
  • Reaction to the anesthesia
  • Kidney, lung, or heart damage

Your chances for problems are higher for:

  • Having an infection
  • Advanced disease
  • Blood clotting problems
  • Drinking
  • Smoking

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 talk about these risks with your doctor before the surgery.

What to Expect ^

Prior to Procedure

If you need a VAD, it's because your heart's failing. Most likely, you will be on a list to receive a heart transplant. You may already be in the hospital. You may also have:

Leading up to the procedure:

  • Don’t eat at least 8 hours before the procedure.
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to 1 week in advance.

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure

This is an open heart surgery. A cut will be made down the length of the breastbone. The breastbone will then be split open. A machine will replace heart and lung function during the procedure. The VAD will be placed into a pocket on the inside of the belly wall. Tubes will be sewn to the heart. Tubes may also be sewn to the aorta. This will depend on the type of device needed.

Immediately After Procedure

You will be in the intensive care unit (ICU). You will be connected to many tubes. The healthcare staff will watch you.

How Long Will It Take?

About 4-8 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Medicines will help ease pain after.

Average Hospital Stay

  • 2-5 days in the ICU
  • 2-4 weeks in a hospital room

Postoperative Care

At Home

To help with your recovery at home:

  • If you’re waiting for a heart transplant, stay in touch with your healthcare team.
  • Take care of your VAD as advised.
  • Take care of the wound to prevent infection.

Call Your Doctor ^

Call your doctor if any of these occur:

  • Fever or chills
  • Redness, swelling, pain, bleeding, or pus from the wound
  • One-sided weakness, blurry vision, or inability to talk
  • A cold, pale or blue, numb, or painful extremity
  • Coughing, breathing problems, or chest pain
  • Nausea or vomiting
  • Problems passing urine
  • Problems moving your bowels
  • Redness or swelling in legs
  • Warning indications from the device

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Heart Association
http://www.heart.org

US Food & Drug Administration
https://www.fda.gov

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Heart and Stroke Foundation
http://www.heartandstroke.ca

REFERENCES:

Left ventricular assist devices (mechanical circulatory support MCS). Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17192-left-ventricular-assist-devices-mechanical-circulatory-support-mcs. Updated February 2015. Accessed July 25, 2018.

Mechanical circulatory support for heart failure. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T483099/Mechanical-circulatory-support-for-heart-failure. Updated May 18, 2018. Accessed July 25, 2018.

Slaughter M, Rogers JG, Milano CA, et al. Advanced heart failure treated with continuous-flow ventricular assist device. N Engl J Med. 2009;361(23):2241-2251.

Ventricular assist device. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/St-Wr/Ventricular-Assist-Device.html. Accessed July 25, 2018.

3/6/2013 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T483099/Mechanical-circulatory-support-for-heart-failure: 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 July 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 7/25/2018