Know About The Insertion Of The Ventricular Assist Device (VAD)

Cardiac Surgery | by Dr. Manoj Kumar Daga | Published on 02/02/2023

What is a ventricular assist device (VAD)?

A ventricular assist device is a mechanical pump that circulated blood from the lower chamber of your heart (ventricle) to the rest of the body. The tiny device is surgically implanted in one or both ventricles of the heart. Depending on the location and severity of the condition, the surgeon performs open-heart surgery to insert VAD.

Here are some common types of VADs -

• Left ventricular assist device (LVAD) - It is the most common type of VAD which is implanted in the left ventricle to pump oxygen-rich blood from the heart out to the body.
• Right ventricular assist device (RVAD) - The doctor implants VAD in the right ventricular to pump oxygen-poor blood from the right side of your heart to the lungs.
• Biventricular assist device - Cardiologists use this type of VAD to assist both sides of the heart
• Pediatric VADs - These are small devices with tiny cannulas and pumps. These devices are customized to fit newborns and young children.

Why Is a ventricular assist device (VAD) Procedure Done?

The surgeon recommends a VAD procedure for several reasons concerning heart issues. A VAD can be implanted temporarily to bridge the gap while you are waiting for a heart transplant donor. A VAD can keep the blood pumping through the body even if the heart is damaged and also contribute to the smooth functioning of the other organs.

Ventricular assist devices are increasingly used as a permanent treatment for patients who are not the ideal candidate for a heart transplant and are at a high risk of heart failure. Also known as destination therapy, this type of procedure can significantly improve the quality of life.

VAD may also be recommended temporarily in case the heart failure is temporary. The surgeon may implant the VAD until your heart can pump enough blood on its own. However, it is important to discuss your medical condition with the doctor to know the risk and benefits of the procedure to reduce the chances of complications during the procedure.

What Happens During a Ventricular Assist Device (VAD) Procedure?

Here is what you can expect during the ventricular assist device (VAD) procedure -

• The anesthesiologist administers general anesthesia to sedate you and temporarily prevent any pain and discomfort during the procedure. After you are asleep, a ventilator is placed which takes over your breathing for the duration of the surgery.
• Then, the surgeon makes an incision in the middle of the chest and opens the sac around your heart. Subsequently, a cardiopulmonary bypass machine is used to keep the blood flowing through your body and restrict the blood flow through your heart.
• The surgeon then implants the VAD into the required area of the heart. After the device is implanted, the surgeon begins the device and you’re removed from the bypass machine as they speed up the VAD to support your circulatory needs.
• Once the surgeon is satisfied with the working of the VAD, the sternum is brought back together with metal wires. Finally, the incision is closed with absorbable sutures and a sterile dressing is applied.

FAQs

1. What are the diagnostic tests recommended before inserting the ventricular assist device (VAD)?

2. What are the benefits of a ventricular assist device (VAD)?

3. Are there any side effects of ventricular assist devices (VAD) implant surgery?

4. Which patients are not eligible for ventricular assist devices (VAD)?