Mechanical Circulatory Assist Device
According to the American Heart Association, there are 5,000,000 people diagnosed with congestive heart failure in America and 550,000 new cases reported each year. Optimal medical management provides some relief of heart failure symptoms and even may be able to slow down and reverse disease processes. Unfortunately, when the disease progresses, there are not many options available.
In the last 20 years, implantable mechanical assist devices, called Ventricular Assist Devices (VADs), became available as an alternative treatment option for heart failure patients.
About the Device
A VAD is a pump which is implanted inside a patient's chest to provide support for the failing heart and improve symptoms of heart failure. The pump needs a power source to function. The power source, ether batteries or Power Base Unit, remain outside of the body. A special line, called a driveline, connects the pump to a controller and a power source.
The VAD is surgically implanted. The surgery usually takes 4-6 hours, and it is done under general anesthesia. After the surgery, the patient is moved to the Intensive Care Unit for recovery. If there are no complications, the patient is discharged from the hospital in 14-21 days. If the function of the heart improves with the support of the VAD, the device can be explanted. Although, this is not common.
Patients with VAD support cannot swim or submerge themselves in water. However, when the driveline site is completely healed, they will be able to take a shower using a specially designed VAD shower kit.
You need to be approved for traveling by the VAD team â€” including your cardiologist, surgeon, and VAD coordinator. Also, you will be provided with a letter which explains travel-related issues for VAD patients such as the necessity to avoid magnetic airport gates, etc.
You will continue taking heart failure medications. Also, you will be taking medications to prevent development of clots.
The complications could include but are not limited to: driveline infections, gastrointestinal bleeding, pump clotting, or device failure.
Patients with advanced heart failure not responding to optimal medical management can be considered for a VAD. Also, VADs can be used in patients who wait for heart transplantation as temporary mechanical support known as a "bridge to transplant."Finally, VADs have been used in patients with end-stage heart failure as "destination therapy"when they are not transplant candidates.
The ideal Body Mass Index for VAD candidates is below 35. However, there is no weight limit set for VAD patients.
UF Health VAD Program clinical trials
UF Health has been a leader in the area of VADs for over 20 years. We have been a clinical trial site for all of the most advanced pumps available, and were the only trial site in Florida for the Heartmate 2 Ventricular Assist Device Destination Therapy clinical trial. Our participation in the research of this advanced heart pump was instrumental in their receiving FDA approval recently for Destination Therapy.
For more information on this new technology, visit www.thoratec.com.
UF Health continues to participate in clinical research trials for both Bridge to Cardiac Transplantation as well as Destination Therapy. The team at Shands is committed to offering the most technologically advanced therapy available for advanced heart failure patients.