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by Scholten A

Heart Assist System Implantation

(Ventricular Assist Device; VAD)

Definition

A heart assist system implantation is a procedure to install a mechanical heart pump. The heart pump is also called a ventricular assist device (VAD).
Left Ventricular Assist Device
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Reasons for Procedure

A VAD helps the heart pump blood. It is used for people with heart failure. Heart failure is when the heart is too weak to pump the blood the body needs.
A VAD may be used for those who:
  • Have short-term heart failure—and need help until the heart gets healthy
  • Are waiting for a heart transplant
  • Cannot get a heart transplant
  • Have not been helped by other treatment
  • Have a low risk of surviving 1 year

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
  • Excess bleeding
  • Problems from anesthesia
  • Infection
  • Damage to other organs or structures
Things that raise the risk of problems are:
  • Smoking
  • Drinking alcohol
  • Long-term diseases such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:
  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor will give general anesthesia. You will be asleep.

Description of the Procedure

An incision will be made down the length of the breastbone. The breastbone will then be opened. A machine will replace heart and lung function during the procedure. The VAD will be placed into a pocket inside the belly wall. Tubes will be sewn to the heart. Tubes may also be sewn to the aorta. This will depend on the type of device needed. The incision will be closed with stitches or staples. A bandage will be placed over the site.

How Long Will It Take?

About 4 to 8 hours

Will It Hurt?

Pain and swelling are common in the first few weeks. Medicines and home care help.

Average Hospital Stay

  • 2 to 5 days in the ICU
  • 2 to 4 weeks in a hospital room

Postoperative Care

At the Hospital
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home
Recovery takes about a few weeks. Some activities will be limited during that time.

Call Your Doctor

Call your doctor if you have:
  • Fever or chills
  • Redness, swelling, pain, bleeding, or discharge from the wound
  • One-sided weakness, blurry vision, or inability to talk
  • A cold, pale or blue, numb, or painful hand or foot
  • Coughing, problems breathing, or chest pain
  • Lasting nausea or vomiting
  • Problems passing urine or stool (poop)
  • Redness or swelling in legs
If you think you have an emergency, call for medical help right away.

RESOURCES

American Heart Association
http://www.heart.org
US Food & Drug Administration
https://www.fda.gov

CANADIAN RESOURCES

Health Canada
https://www.canada.ca
Heart and Stroke Foundation
http://www.heartandstroke.ca

References

Left ventricular assist devices (mechanical circulatory support MCS). Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17192-left-ventricular-assist-devices-mechanical-circulatory-support-mcs. Accessed September 2, 2021.
Mechanical circulatory support for heart failure. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/mechanical-circulatory-support-for-heart-failure. Accessed September 2, 2021.
Shaffer A, Cogswell R, el al. Future developments in left ventricular assist device therapy. J Thorac Cardiovasc Surg. 2021;162(2):605-611.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/02/2021