Ventricular assist device

Ventricular assist device
Intervention
A left ventricular assist device (LVAD) pumping blood from the left ventricle to the aorta, connected to an externally worn control unit and battery pack.
MedlinePlus	007268
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A ventricular assist device (VAD) is an electromechanical device for assisting cardiac circulation, which is used either to partially or to completely replace the function of a failing heart. The function of VADs is different from that of artificial cardiac pacemakers; some are for short-term use, typically for patients recovering from myocardial infarction (heart attack) and for patients recovering from cardiac surgery; some are for long-term use (months to years to perpetuity), typically for patients suffering from advanced congestive heart failure.

VADs are distinct from artificial hearts, which are designed to assume cardiac function, and generally require the removal of the patient's heart. Moreover, VADs are designed to assist either the right ventricle (RVAD) or the left ventricle (LVAD), or to assist both ventricles (BiVAD). The type of ventricular assistance device applied depends upon the type of underlying heart disease, and upon the pulmonary arterial-resistance, which determines the workload of the right ventricle. The left-ventricle assistance device (LVAD) is the most common device applied to a defective heart (as it is sufficient in most cases -the right side of the heart is then often already able to make use of the heavily increased blood flow-), but when the pulmonary arterial-resistance is high, then an (additional) right-ventricle assistance device (RVAD) might be necessary to resolve the problem of cardiac circulation. If both a LVAD and a RVAD is needed a BiVAD is normally used, rather than a seperate LVAD and an RVAD.

Normally, the long-term VAD is used as a bridge to transplantation (BTT) — keeping the patient alive, and in reasonably good condition, and able to await the heart transplant outside of the hospital. Other "bridges" include bridge to candidacy, bridge to decision, and bridge to recovery. In some instances VAD's are also used as destination therapy (DT). In this instance, the patient shall not undergo a heart transplantion and the VAD is what the patient will use for the remainder of his life.