Ventricular Assist Devices (VADs)
What is a VAD?
A ventricular assist device (VAD), also known as a mechanical circulatory support device, is used to treat patients with advanced heart failure. Congestive heart failure affects nearly 5 million people in the United States and can be caused by obesity, high blood pressure or coronary artery disease. In some cases, there is no known cause. A left ventricular assist device (LVAD), which is implanted to assist the left ventricle, is the most commonly used type of VAD.
VADs at UK HealthCare
Congestive heart failure can progressively worsen until heart transplantation or a VAD may be needed to help relieve symptoms. The multidisciplinary team at UK HealthCare works together to determine which option is best for each patient. The LVAD can be used to serve three different purposes:
- Bridge to transplant: Some patients receive an LVAD as a temporary solution to sustain their health until a donor is found for a heart transplant.
- Destination therapy: Some patients receive an LVAD as a permanent solution to advanced heart failure.
- Bridge to recovery: Occasionally an LVAD is used temporarily to allow a patient’s heart to regain strength and then the LVAD is removed.
Parts of an LVAD
An LVAD has both internal and external components that aid the heart in pumping blood through the body. It is important for a patient receiving an LVAD to understand how it operates because he or she will need to perform required daily maintenance and upkeep. A thorough understanding of the equipment will help patients more easily recognize when something is wrong. Through advanced technology, LVADs are now extremely compact and allow patients to have much more freedom from home.
Internal components of an LVAD:
- Pump: The pump is the internal mechanism that is connected to the heart. This pump aids the left ventricle in pumping blood to the aorta, which is then distributed to the rest of the body to help other body parts function.
External components of an LVAD
- Driveline: The driveline is a tube that connects the pump (internal) to the controller (external). The driveline exits from the skin on the abdomen and must be connected to the controller at all times to keep the LVAD working properly.
- Controller: The controller is the “motherboard” of the LVAD machine and operates the pump to keep the heart working. If anything is wrong with the system, the controller alerts the user with alarms and lights. The driveline is hooked to the controller, and the controller is hooked to the battery pack/ power source. The controller must remain hooked to a power source at all times.
- Battery pack/power source: The battery pack/ power device is a vital part of the LVAD. Without some source of battery/electricity, an LVAD will not operate. For functionality while on the move, battery packs can be worn discreetly over the shoulder in a backpack-type of carrier. Some LVADs are designed to adapt to car outlets for charging. It is very important for patients to ALWAYS remember extra batteries when away from home, even for a short trip. The LVAD can be charged through an electrical outlet in the wall while sleeping.
LVAD surgery basics
A team of specialists at UK HealthCare supports and comforts patients and their loved ones throughout the LVAD surgery process. Social workers, financial advisors and pastoral staff are also available upon request.
Living with an LVAD
Several aspects of a patient’s normal routine must change after LVAD surgery. Showering, exercise, sleeping and intimacy are just a few examples of tasks that must be adjusted when living with an LVAD. Caution should always be taken around people, pets or objects that may affect the functioning of an LVAD.
- Nutrition: It is important to keep a balanced diet. A good diet will aid in faster recovery from surgery and improve overall health. Heart healthy foods include whole grains, fish, and a variety of fruits and vegetables. UK HealthCare dietitians help patients learn how diet can improve quality of life.
- Physical activity: Although LVAD patients may not be able to actively participate in physical activity like they did prior to surgery, it is still vital that they participate in some form of exercise. Physical activity will not only improve overall health, it is also a great way to socialize. Patients should consider participating in group classes at a local gym once they feel strong enough to do so.
- Hygiene: Showering with an LVAD is somewhat challenging because an LVAD must ALWAYS be hooked up to a power source and is not waterproof. Patients should not become discouraged. Nurses and physicians will offer showering tips and advice.
- Intimacy: Intimacy is still possible with LVAD equipment. Caution should always be used around the external components of LVAD equipment, but with practice, intimacy is not a problem. Women should not become pregnant with an LVAD implant.
- Travel: Patients should feel free to travel with an LVAD. The devices are designed to keep users mobile. Plane, train and automobile travel are all acceptable. However, patients must always remember to take back-up batteries wherever they go.