June 23, 2026
Advances in ventricular assist device (VAD) technology are transforming the treatment landscape at Mayo Clinic for patients with advanced heart failure, offering longer survival and improved quality of life for individuals who previously had limited or no therapeutic options.
VADs are durable mechanical circulatory support devices that assist the heart by pumping blood from the lower chambers of the heart to the rest of the body. The treatment requires open-heart surgery. For patients with advanced heart failure, particularly those who are not candidates for heart transplantation, these devices can be lifesaving.
Evolving heart failure therapy
Heart failure affects approximately 6.7 million Americans and is projected to rise significantly in coming decades. Advanced (stage D) heart failure carries poor one year survival (6% to 25%) without advanced therapies. At the same time, a shortage of donor hearts continues to limit access to transplantation.
"VAD therapy has evolved into a transformative and durable treatment, significantly improving both survival and quality of life," says Mauricio A. Villavicencio, M.D., M.B.A., a cardiovascular and transplant surgeon at Mayo Clinic in Rochester, Minnesota. Dr. Villavicencio is Mayo Clinic's surgical director of Heart and Lung Transplantation and Mechanical Circulatory Support. "With contemporary devices and management, we've seen reductions in complications such as pump thrombosis, stroke and gastrointestinal bleeding."
A novel VAD implant approach developed at Mayo Clinic now enables treatment for patients with advanced heart failure who are not candidates for transplant — marking a critical expansion of care options.
Double VAD support
While temporary circulatory support devices are used in intensive care settings, durable VADs can be implanted surgically, allowing patients to return home and resume daily activities with improved quality of life.
Traditionally, VAD therapy involves supporting the left ventricle (LVAD). However, some patients present with biventricular failure — requiring support for both sides of the heart.
Mayo Clinic recently performed Minnesota's first implantation of a double magnetically levitated VAD system in a 40-year-old patient with severe biventricular failure and cardiogenic shock. The patient, who was not a transplant candidate, required veno-arterial ECMO for survival.
Dr. Villavicencio and his multidisciplinary team developed and implemented a novel surgical technique to provide effective support to both the right and left ventricles. "The patient was ambulatory shortly after surgery and discharged home, where he continues to do well eight months later. Younger VAD patients can often begin walking within a day and recover quickly," Dr. Villavicencio says. "Avoiding both heart failure and long-term immunosuppression may also extend their lifespan."
Lifesaving surgical innovation
Recent advances in LVAD design and surgical technique are driving improved outcomes:
- Magnetically levitated continuous-flow pumps resulting in near elimination of pump thrombosis.
- Reduced stroke and bleeding risks, with some patients requiring only warfarin and no aspirin.
- Improved survival approaching approximately 88% at one year — comparable to heart transplantation in selected populations.
In addition to device improvements, surgical innovations are enhancing right ventricular support:
- Implantation of VADs in the right atrium.
- Use of felt standoffs to reduce suction events.
- Strategic fixation within the right chest cavity.
"We've implanted double VADs in three critically ill patients, with excellent clinical results — all patients were successfully discharged from the hospital," Dr. Villavicencio says.
Looking ahead
Mayo Clinic's advanced cardiovascular care capabilities are enabling high-risk, complex procedures for patients who otherwise lack treatment options. "For individuals with severe right heart failure, double VAD, called biventricular, therapy offers a promising new path forward," Dr. Villavicencio says. "A large, underserved population exists, and modern VADs are delivering outcomes approaching transplant-level survival in some groups, making them a cornerstone of advanced heart failure care."
For more information
Refer a patient to Mayo Clinic.