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Ventricular Assist Device (VAD) + Mechanical Circulatory Support

A person who has faced a heart attack, cardiogenic shock or advanced heart failure may require mechanical circulatory support to pump blood throughout their body when the weakened heart can't. That's where a ventricular assist device (VAD) comes in — it's a type of long-term or short-term treatment to help your vital organs get the right amount of blood.

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Support for you + your heart

Your heart is made up of 2 atriums and 2 ventricles. Your left and right ventricles are like little rooms in your heart that collect blood and pump it out of the heart. From there, the blood circulates to the rest of your body.

When you have a condition that affects your ventricles, your heart might need extra support to function properly. A ventricular assist device can help your heart get back on track by regulating blood flow and heart function.

Followup biopsy procedure on heart transplant patient in the Cath Lab at Tufts Medical Center by attending physician, Navin Kapur, MD and Colin Hirst, MD.
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Conditions

Mechanical circulatory support helps the heart by regulating circulation and making sure that blood and oxygen get to vital organs. If you have any of the following conditions, you may need acute mechanical circulatory support.

Biventricular failure
Cardiogenic shock
End-stage heart failure
Heart attack
Left ventricular heart failure
Myocarditis
Right ventricular heart failure

People who underwent a major procedure like the following may also benefit from mechanical circulatory support:

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Treatments

If you’re experiencing any of the above conditions, we may recommend a VAD to regulate your blood flow and heart function or turn to other mechanical circulatory support approaches.

Mechanical circulatory support

When you’re living with advanced heart failure, mechanical circulatory support steps in to help your heart pump enough blood. These treatment approaches can be temporary or permanent, depending on your condition.

Intra-aortic Balloon Pump (IABP)

AN IABP is a catheter (a flexible tube) with a balloon at one end. We’ll place this balloon into your aorta (your body’s largest artery) to help your heart pump more blood. The other end of the catheter connects to a computer, which tells the balloon when to inflate and deflate.

When your heart relaxes, the balloon inflates, pushing blood back to your coronary arteries. Then when your heart contracts, the balloon deflates, making it easier for your heart to get blood throughout your body.

Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO)

VA-ECMO helps your body get oxygenated blood during cardiorespiratory collapse (shock), cardiac arrest and myocarditis. It works by acting as your heart and lungs, removing carbon dioxide and adding oxygen to your blood. It then pushes this oxygenated blood through your body.

New technology

As experts in mechanical circulatory support, we’re always on the lookout for new technology that can improve your quality of life. That’s why we’re one of the first to participate in clinical trials for pumps not widely available throughout the United States, like:

  • Ambulatory Acute MCS
  • Axillary IABP 
  • Impella RP®
  • Tandem Protek RVAD 
  • Thoratec PHP

Ventricular assist devices (VADs)

A VAD is a mechanical pump that's surgically implanted into the chest when heart function is severely impaired. Most of the time, VADs are implanted in the left ventricle, which is the main pumping chamber of the heart.

VADs are easy-to-operate devices powered by an electricity source from outside the body — all you’ll need to know is how to change power sources and respond to alarms. We’ll also teach you how to change a controller in case of an emergency.

It’s important to remember that heart failure affects the entire body, including your muscles. Some people continue to have symptoms, like weakness, after receiving a VAD. Most people require physical therapy after surgery, and it can take up to 6 months until strength and conditioning is fully restored.

Types of VADs

Your doctor may recommend one of the following left ventricular assist devices (LVAD) to provide left ventricular support:

  • CentriMag™ LVAD
  • IABP
  • Impella CP®
  • Impella 5.0®
  • TandemHeart® LVAD
  • VA-ECMO

If your heart needs right ventricular support, you may be a candidate for the following right ventricular assist devices (RVAD):

  • CentriMag™ RVAD
  • Impella RP®
  • TandemHeart® RVAD
  • VA-ECMO

Should your heart need biventricular support (meaning both sides of the heart are failing), your doctor may recommend one of these pumps:

  • CentriMag™ BiVAD
  • Impella®
  • BiPella
  • TandemHeart® Bi-VAD
  • VA-ECMO
BiPella

Biventricular failure happens when both of the ventricles are unable to pump blood out from the heart through the rest of the body. To treat this condition, we’ll use BiPella, which is made up of 2 pumps that can support both ventricles.

Impella 5.0®

The Impella 5.0® is a small, catheter-based pump that’s placed in the left ventricle. The pump transfers energy to the bloodstream, creating continuous blood flow throughout the body. The Impella pump can help you start physical therapy and get moving around sooner, even as you recover from advanced heart failure.  

TandemHeart®

The TandemHeart® lets blood bypass the left ventricle and go directly to the left atrium. From there, blood passes to the aorta, which carries the blood to the rest of the body.

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FAQs

What type of LVAD will I need?

Your care team will evaluate your condition and determine the best option for you. Currently, the only FDA-approved device available is the Abbott HeartMate 3. However, investigational devices may sometimes be accessible through participation in a clinical trial.

How long will I need an LVAD?

It depends on what and how the LVAD will support you and your care. There are 2 reasons a LVAD may be recommended:

  • Bridge therapy: Designed to keep you stable and physically active as you wait for a heart transplant or until the heart function recovers. The LVAD is temporary and removed. 
  • Destination therapy: In cases of end-stage heart failure, the LVAD can be a permanent solution when a heart transplant is not an option. In these situations, it is unlikely that the LVAD will be removed unless the heart has fully recovered.
     
How long is the battery life for my LVAD?

Battery life can last between 8–14 hours. Each LVAD comes with 3 sets of batteries, so you can go freely about your day without worrying about recharging batteries. To prevent your LVAD's battery from draining, it is recommended to connect it to a power source (to a wall outlet) while you sleep at night.

Can I return to work after receiving my LVAD?

Some people are able to return to work depending on their job responsibilities. We strongly recommend speaking with your doctor first before returning to work.

Can I travel with my LVAD?

Traveling with an LVAD is possible and requires thoughtful planning. You can even go on airplanes. We can provide local contact information for LVAD hospitals should a visit be necessary.

Can I drive if I have an LVAD?

People with an LVAD are able to drive once fully healed, which is about 8–10 weeks after after surgery. Your care team will need to clear you before you start driving again.

Can I go swimming if I have an LVAD?

No, you cannot go swimming if you have an LVAD.

Can I shower shortly after surgery for my LVAD?

Showering is possible about 6 weeks after surgery with the use of protective equipment to prevent the controller and batteries from getting wet.

Will I need a full time caregiver after my LVAD surgery?

Receiving an LVAD requires a big commitment for you, your caregiver and your medical team. You must have full-time support at home with a caregiver knowledgeable about caring for the device in emergencies for the first several weeks and months after the surgery.

Certain patients may need to be transferred to an acute rehabilitation hospital before they can go back home. Typically, long-term care facilities for patients with LVAD are not available for those who still require significant support at home. It's very important for you to have support in place before your surgery in case of a major complication and you're unable to care for yourself.

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