A ventricular assist device (VAD) is a mechanical device that supports the lower left heart chamber (left ventricular assist device, or LVAD), the lower right heart chamber (right ventricular assist device, or RVAD) or both lower heart chambers (biventricular assist device, or BIVAD).
Your doctor may recommend you have a VAD implanted if:
You're waiting for a heart transplant. You may have a VAD implanted temporarily while you wait for a donor heart to become available.
A VAD can keep blood pumping despite a diseased heart and will be removed when your new heart is implanted. It may also help improve the function of other organs in your body that may not be working properly and may improve other medical conditions.
When a VAD is implanted while you're waiting for a heart transplant, it's referred to as a "bridge to transplant."
You're not currently eligible for a heart transplant because of other conditions. A VAD may sometimes be implanted if you have heart failure, but you're not yet eligible for a heart transplant due to other medical conditions. Your doctor may not have decided whether you're eligible for a heart transplant or a VAD as a permanent treatment. When a VAD is implanted for this reason, it's called "bridge to candidacy" or "bridge to decision."
The VAD may help improve the function of other organs that aren't working properly or improve other medical conditions that may be keeping you from being a candidate for a heart transplant. In some cases, the VAD may improve these conditions so that you can become a heart transplant candidate, or you may keep the VAD as a permanent treatment.
Your heart's function can become normal again. If your heart failure is temporary, your doctor may recommend implanting a VAD until your heart is healthy enough to pump blood on its own again. This is referred to as "bridge to recovery."
It's also possible you'll have a VAD implanted for a short time during or after having heart surgery. You may have a VAD implanted for a few weeks or months.
RVADs may be temporarily implanted after some heart surgeries. An RVAD can help keep blood flowing from the right ventricle to your lungs.
You're not a good candidate for a heart transplant. VADs are increasingly being used as a long-term treatment for people who have heart failure but aren't good candidates for a heart transplant. Generally if you're older than age 65, you may not be eligible for heart transplantation. In that situation the VAD would be implanted as therapy for heart failure. A VAD can enhance your quality of life.
When a VAD is implanted as a permanent treatment for heart failure, it's referred to as "destination therapy."
If a VAD can't help your heart, your doctor may consider a total artificial heart as a treatment option. This device replaces the two lower heart chambers (ventricles) of your heart. This option is generally only considered in people with severe heart failure whose conditions haven't improved through other treatments. It may be an option while you're waiting for a heart transplant. Your doctor will discuss with you whether a total artificial heart is an appropriate treatment option for you.
March 04, 2017
- What is a ventricular assist device? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/vad. Accessed Aug. 10, 2015.
- What is heart failure? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hf. Accessed Aug. 10, 2015.
- Aroesty JM, et al. Circulatory assist devices: Cardiopulmonary assist device and short-term left ventricular assist devices. http://www.uptodate.com/home. Accessed Aug. 3, 2015.
- Yancy CW, et al. 2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128:e240.
- Implantable medical devices for heart failure. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Implantable-Medical-Devices-for-Heart-Failure_UCM_306354_Article.jsp. Accessed Aug. 10, 2015.
- Birks EJ. Intermediate- and long-term mechanical circulatory support. http://www.uptodate.com/home. Accessed Aug. 3, 2015.
- What is a total artificial heart? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/tah. Accessed Aug. 11, 2015.
- AskMayoExpert. What are the therapeutic options for the various stages of heart failure? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Stulak JM, et al. Ventricular assist device selection: Which one and when? Croatian Medical Journal. 2014;55:596.
- Mancini D. Practical management of long-term mechanical circulatory support devices. http://www.uptodate.com/home. Accessed Aug. 3, 2015.
- Mancini D, et al. Left ventricular assist devices: A rapidly evolving alternative to transplant. Journal of the American College of Cardiology. 2015;65:2542.
- Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Aug. 4, 2015.
- What is cardiac rehabilitation? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/rehab/. Accessed Aug. 13, 2015.
- Givertz MM. Ventricular assist devices: Important information for patients and families. Circulation. 2011;124e:e305.
- Kirkpatrick JN, et al. Ventricular assist devices for treatment of acute heart failure and chronic heart failure. Heart. 2015;101:1091.
- Bonow RO, et al. Mechanical circulatory support. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Sept. 25, 2015.
- Murray MJ, et al. Management of end-stage heart failure: Heart transplantation and ventricular assist devices. In: Faust's Anesthesiology Review. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Sept. 25, 2015.
- La Franca E, et al. Heart failure and mechanical circulatory assist devices. Global Journal of Health Science. 2013;5:11.
- Barbara Woodward Lips Patient Education Center. Getting ready for heart surgery. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
- How can I prepare for heart surgery? American Heart Association. https://www.nlm.nih.gov/medlineplus/heartsurgery.html. Accessed Sept. 25, 2015.
- Cheung A, et al. Design concepts and preclinical results of a miniaturized HeartWare platform: The MVAD system. Innovations. 2015;10:151.
- First woman receives an artificial heart implant. The New York Times. Dec. 20, 1985. http://www.nytimes.com/1985/12/20/us/first-woman-receives-an-artificial-heart-implant.html. Accessed Oct. 12, 2015.
- DeVries WC, et al. Clinical use of the total artificial heart. The New England Journal of Medicine. 1984;310:273.
- Joyce LD, et al. Use of the mini-Jarvik 7 total artificial heart as a bridge to transplantation. The Journal of Heart Transplantation. 1986;5:203.
- U.S. News Best Hospitals 2015-2016. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings. Accessed Oct. 29, 2015.
- Intermacs Quality Assurance Quarterly Report (2015 Q1). Interagency Registry for Mechanically Assisted Circulatory Support, University of Alabama. National Heart, Lung, and Blood Institute. Contract No. HHSN268201100025C. http://www.uab.edu/intermacs. Accessed Nov. 12, 2015.
- Kushwaha SS (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 30, 2015.
- Cecka JM, et al. Clinical Transplants 2003. Los Angeles, Calif.: UCLA Immunogenetics Center; 2004.
- Joyce DL, et al. Mechanical Circulatory Support: Principles and Applications. New York, N.Y.: McGraw-Hill Medical; 2012.
- Joyce LD (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 7, 2016.
Ventricular assist device (VAD)