Transcript Lecture Note 4 - Introduction to VAD

Introduction to Ventricular Assist
Device (VAD)
Introduction to Ventricular Assist
Device (VAD)
WHAT IS VAD AND WHAT DOES IT DO?
It is a pump that assists the heart by pumping blood to the
body. It aids the failing ventricle by taking some of the
work load from the heart.
OR
 a battery-operated device that is designed to help either
one or both ventricles of the heart pump blood. It does not
replace the heart but instead helps the patient's own heart
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pump blood through the body.
OR
 a mechanical device that is used to partially or completely
replace the function of a failing heart.
Introduction to Ventricular Assist
Device (VAD)
OR
 a blood pump designed to help restore the circulation of
blood flow to the body with mechanical circulatory support
(MCS). It works to improve blood flow in concert with your
heart- it does not replace your own heart.
Introduction to Ventricular Assist
Device (VAD)
APPLICATION
 Post-Cardiotomy : after-surgery use to assist recovery of
patient.
 Bridge-to-Transplant : used temporarily while awaiting
transplant.
 Bridge-to-Recovery : recovery from heart failure, in some
cases VAD is removed and patient discharged from hospital.
 Chronic Support : for long term use.
Introduction to Ventricular Assist
Device (VAD)
WHO NEEDS VAD?
 Patients who are awaiting a donor heart and need the VAD
as a “bridge to transplantation.”
 Patients with chronic heart failure who are not candidates
for heart transplantation because of advanced age, kidney
disease or chronic obstructive pulmonary disease.
 Patients who have undergone heart surgery but cannot be
weaned from the heart-lung machine.
Introduction to Ventricular Assist
Device (VAD)
TYPES OF VADs
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Left ventricular assist device (LVAD)-supports only the left
ventricle
Right ventricular assist device (RVAD)-supports only the
right ventricle
Bi-ventricular assist device (LVAD)-supports both ventricles
Introduction to Ventricular Assist
Device (VAD)
How VAD works or operates?
Introduction to Ventricular Assist
Device (VAD)
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During surgery, the surgeon attaches the VAD to the apex
of the left ventricle and to the aorta. When the left ventricle
(the major pumping chamber of the heart) contracts
(systole), blood flows into the VAD pump. When the heart
relaxes (diastole), the left ventricle fills with blood, and the
blood in the device is pumped into the aorta.
The surgeon connects the pump to the heart by using a
tube that is made for this specific use. The blood travels
from the heart, down the inflow tube, and into the
VAD. The VAD then pumps the blood into the outflow tube
and delivers the blood to a major blood vessel. The pump is
usually placed in the upper abdomen and cannot be seen.
The computer for the pump is outside the body and can be
worn with a fanny pack or a belt clip. The pump and the
computer are connected by a small cord that exits the body
via a small opening on the side of the abdomen. The
system can be powered by using batteries or by using an
AC power adapter. The batteries enable the patient
to resume most daily living activities.
Introduction to Ventricular Assist
Device (VAD)
How VAD is placed
Introduction to Ventricular Assist
Device (VAD)
Introduction to Ventricular Assist
Device (VAD)
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Benefits of VAD :
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Relieve symptoms of severe heart failure such
as breathlessness and fatigue.
Short term use to support failing heart before
donor available.
Risk of VAD :
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Bleeding due to implant surgery.
Development of blood clots that cause stroke.
Respiratory and kidney failure.
Device faillure.
Infection.
Introduction to Ventricular Assist
Device (VAD)
VAD Products
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HeartMate ® Implantable
Introduction to Ventricular Assist
Device (VAD)
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HeartMate® II
Introduction to Ventricular Assist
Device (VAD)
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Novacor ® Implantable
Introduction to Ventricular Assist
Device (VAD)
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VentrAssist®
Introduction to Ventricular Assist
Device (VAD)
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Thoratec PVAD
Introduction to Ventricular Assist
Device (VAD)
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Jarvik 2000