by What are Ventricular Assist Devices?
A ventricular assist device (VAD) is a mechanical pump that is used to help a weak or failing heart pump blood to the rest of the body. VADs are implanted next to the heart to take over some or all of the pumping function of one or both ventricles- the lower chambers of the heart. There are different types of VADs, but their main function is the same – to increase blood flow from the heart and improve the amount of blood distributed by the heart.
How do VADs Work?
Most Ventricular Assist Devices have small electric pumps that are placed inside the chest. They connect to a power source outside the body and are connected to hoses that draw blood from the heart’s lower chambers and push blood to the patients’ circulatory system. Sensors in the pump detect the heart rate and adjust pumping accordingly to ensure blood flows throughout the body. There are also wires that connect the pump to a controller on the outside of the body. The controller regulates the pump functions. VADs can also be connected to batteries that allow short-term portable use of the device while the patient is outside a medical facility.
Types of Ventricular Assist Devices
There are different types of VADs depending on how long they are needed:
– Short-Term VADs: Used for a few days or weeks to allow a person’s heart to recover after surgery or as a bridge to recovery from a heart attack.
– Mid-Term VADs: Used for months or possibly years as “bridge to transplant”, keeping someone alive until a donor heart becomes available for transplantation.
– Long-Term VADs: Meant for lifetime use as “destination therapy” for those not eligible for a transplant but still require long-term cardiac support. This is also known as permanent ventricular assistance.
– Biventricular VADs: For cases where both ventricles are severely weakened, two pumps are implanted to support both sides of the heart.
Who Needs a Ventricular Assist Device?
VADs are primarily used for people awaiting heart transplantation and those not eligible for transplantation. Good candidates include individuals with:
– Severe heart failure: When medications alone are not enough to manage heart failure symptoms and quality of life.
– End-stage heart disease: When transplantation is necessary but a heart is not available yet.
– Severe scarring or weakness of the heart: Making pumping blood difficult even with maximal medical therapy.
– Cardiogenic shock or acute heart failure: Where the heart suddenly fails at pumping enough blood.
– Rare heart diseases: Like congenital heart defects or genetic cardiomyopathies.
How is a VAD Procedure Performed?
VAD implants are done surgically through an incision in the chest beneath the breastbone. The pump mechanism is placed in the chest cavity around the heart. Inflow cannula is attached to one of the ventricles and the outflow cannula is anastomosed to the aorta or pulmonary artery. External wires connect the pump to the controller and power source outside the body. Antibiotics protect against infection and blood thinners prevent blood clots. Recovery takes several weeks with rehab including exercises. Most people can return to many daily activities with a VAD.
Benefits of Ventricular Assist Devices
VAD implantation has many potential benefits for patients:
– Improved heart function: By assisting the ventricles in pumping blood, VADs increase cardiac output significantly.
– Better quality of life: Many people notice increased strength, stamina and ability to do normal daily tasks. Hospitalization is less frequent.
– Bridge to transplant: Mid-term VADs allow living until a donor organ becomes available. Over 80% of VAD patients receive a transplant within 2 years.
– Destination therapy: Long-term VADs prolong survival in transplant-ineligible individuals compared to medical therapy alone.
– Lifestyle extension: Patient with advanced heart failure live many extra months or years with good quality of life on permanent VAD support.
Potential Risks and Complications
While life-saving, VADs also pose certain risks that patients should discuss with their medical team:
– Bleeding: Due to blood thinners used to prevent clots in the system. Bleeding may require transfusions or surgery.
– Infection: Pneumonia or driveline exit site infections are common since the external components can introduce bacteria. Blood infections related to VADs are challenging to treat.
– Stroke: Clots forming in the pump or arterial system can cause embolic strokes in 2-5% of VAD patients per year.
– Device malfunction: Rarely parts may wear out, dislodge, or cables become disconnected requiring device repair or replacement.
– Poor quality of life: Some recipients have limitations like difficulty speaking or limited mobility from a large VAD. A small risk of pump pocket complications.
– Long-term outcomes: A permanent VAD is not equivalent to a heart transplant and outcomes depend on new technology and patient health.
The Future of Ventricular Assist Device Technology
VAD design and engineering are rapidly progressing with the goal of making appliances more durable, reliable and natural feeling. Newer devices miniaturize pumps and batteries to avoid surgery for replacements. Some experimental VADs synchronize with heartbeats and may not require anticoagulation. Researchers are also developing wireless external components for greater mobility. Tissue engineering aims to make organic, self-regulating pumps. VAD therapy will likely expand criteria to include less sick patients. For now, VADs provide hope for survival where no other option was available. With continued innovation, outcomes are likely to improve further still.
ventricular assist devices have advanced significantly from the first generation that helped keep hearts pumping until transplantation. Today, VAD implantation provides good quality of remaining life and acts as a true destination therapy for thousands worldwide. Though requiring care and management of potential complications, VADs represent an established life-saving treatment that provides time for organ donation as well as lasting quality years for end-stage heart failure patients. As new technologies increasingly miniaturize devices and improve artificial heart components, the field of mechanical circulatory support continues to revolutionize cardiovascular care.
*Note:
1. Source: Coherent Market Insights, Public Source, Desk Research
2. We have leveraged AI tools to mine information and compile it.
About Author - Priya Pandey
Priya Pandey is a dynamic and passionate editor with over three years of expertise in content editing and proofreading. Holding a bachelor's degree in biotechnology, Priya has a knack for making the content engaging. Her diverse portfolio includes editing documents across different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. Priya's meticulous attention to detail and commitment to excellence make her an invaluable asset in the world of content creation and refinement. LinkedIn Profile
