Ventricular Assist Devices
Joint Commission Advanced Certification
Jefferson is proud to receive advanced certification in Ventricular Assist Devices (VAD).
More than 5 million patients are living with heart failure, and 550,000 new cases are reported every year. The most common reasons for heart failure are coronary artery disease, hypertension and diabetes. Heart transplantation used to be the only option for these patients. Unfortunately, there are fewer hearts available for transplantation than the number of people who need them.
For patients who are unable to receive a transplant, or who cannot wait long enough for a heart to become available, new types of heart pumps called ventricular assist devices – also known as VADs – provide the support these patients need. The pumps available today are much smaller and more durable than devices that were available even 10 years ago.
A VAD is a mechanical device that takes over the pumping function of the heart and can support the heart in order to ensure the amount of blood delivered to the body is enough to meet the patient’s needs. These devices help to relieve heart failure symptoms, such as shortness of breath when walking short distances.
Our care team evaluates patients to determine which type of VAD is likely best for them, or if heart transplantation is a better option.
How is a Ventricular Assist Device Used?In order to receive a VAD as a bridge to transplantation, patients need to meet very specific criteria. The two main reasons to place a VAD include:
- Bridge to Transplantation – when a VAD is placed in a patient who is waiting for a heart transplant. In this situation, the VAD is intended to allow the patient to survive until a donor heart is available, or to allow a condition to improve so that the patient can then get a heart transplant. To receive a VAD as a bridge to transplantation, a patient has to meet the criteria for transplantation and be sick enough that a VAD is necessary.
- Destination Therapy – when a VAD is placed with the intention of it being permanent support. For destination therapy, patients must meet criteria established by Medicare. Your Jefferson cardiologist can determine if you meet these criteria.
How Does a Ventricular Assist Device Work?
The ventricular assist device will be placed below or in your heart and will be attached to your aorta (a large blood vessel which carries blood from your heart to the rest of your body). Surgeons will implant the device and connect it to your heart and aorta through a chest incision. A rotor in the pump spins at a fast rate and pushes the blood from the left ventricle of the heart into the aorta to the rest of the body.
There will be a tube (driveline) passing through the skin of your abdomen. The driveline contains the power cable. The driveline is connected to a small computer (controller) which is then connected to a special power supply. If receiving the Jarvik 2000, the driveline passes through the skin behind the left ear.
A modern VAD is designed for long-term use. Many patients are supported on a VAD for years. If the device fails or clots, it may need to be replaced through a second operation. If the patient undergoes heart transplantation, the VAD is removed at that time. Uncommonly, the patient’s own heart recovers enough that the device can be removed.
While a patient is supported on a VAD, they will need to be seen on a regular basis by the VAD coordinators, heart failure cardiologist and heart surgeons to make sure they are doing well. This occurs weekly in the beginning, but can usually be changed to less frequently when things are going well. The frequency of these visits are determined by your medical team based on your condition.
Risk Factors of Receiving a VAD
The following risk factors may have an effect on the outcome of receiving an implanted ventricular assist device:
- Kidney failure
- Liver failure
- History of stroke
- Previous heart surgery
- Severe right-side heart failure
Why Choose Jefferson for Heart Care in Philadelphia?
If you are a candidate for a ventricular assist device, the staff of Jefferson's Mechanical Circulatory Support Program – along with the Advanced Heart Failure and Cardiac Transplant Center – will provide exceptional care and a healing environment. A knowledgeable and skilled team of physicians, surgeons, nurse coordinators, physician assistants, psychologists, pharmacists, dietitians, researchers and staff with robust expertise and state-of-the-art resources will support you.