What is an VAD?

VAD stands for Ventricular Assist Device. It is an artificial heart pump that is used to treat end stage heart failure. It can be used as a bridge to heart transplant or as "destination" for patients who are not candidates for a heart transplant. In some cases it can also be used as a temporary measure while the heart recovers from injury.

There are several different types of VADs. This is a picture of the HeartWare VAD.

The VAD can be used to support either the left or the right side of the heart. There is also a device called a BiVAD which supports both sides. The most common use is to support the left ventricle.

The device is implanted during open heart surgery. The pump is attached to the left ventricle and the aorta which effectively takes the place of the pumping of the left ventricle. This allows the left ventricle to rest. After surgery the patient goes to the ICU and is closely monitored. Recovery time in the hospital can range from 10 days to 4-6 weeks. 

The bottom of the pump has a cord coming out called the driveline. It exits the body through an abdominal wound. 

The driveline must be carefully cared for because there is a high risk of infection. The dressing needs to be changed with strict sterile technique. The frequency of dressing changes depends on the person.

The driveline is connected to a small computer called a controller. The controller must be connected to two sources of power at all times. This can be batteries, wall power or a car charger. This is a picture of the controller and its batteries. The device pictured is also connected to a monitor which is used in the hospital to adjust the LVAD settings.

Patients with an LVAD can do activity as tolerated. They cannot take a bath or swim. The settings must be carefully monitored each day. The patient and a caregiver need to be trained in the use of the device and emergency procedures. 

LVADs have come a long way in the last several years. What was once experimental technology the size of a suitcase can now allow patients with heart failure to lead relatively normal lives.