Ventricular Assist Device

What Is a Ventricular Assist Device?

A ventricular assist device is a mechanical pump that takes over for the heart and pumps blood. This can give a weak or injured heart time to heal or support someone as they wait for a heart transplant.

What Does a Ventricular Assist Device Do?

The heart has four chambers, a left atrium and right atrium and a left ventricle and right ventricle. Normally, the left ventricle pumps blood through the aorta to the body, and the right ventricle pumps blood through the pulmonary artery to the lungs.

Sometimes, though, one or both ventricles are damaged and can’t pump blood. When this happens, a ventricular assist device can take over the work of pumping blood.

Why Is a Ventricular Assist Device Placed?

Surgeons may place a ventricular assist device (VAD) to:

Give the heart time to recover.
Help the heart while someone waits for a heart transplant.
Help the heart while doctors decide if a heart transplant will help a person.
Help the heart if someone cannot get a heart transplant.

Some ventricular assist devices stay in place for days to weeks. Others may be needed for a year or longer.

Who Needs a Ventricular Assist Device?

Most people who get a ventricular assist device need it because they have heart failure. Heart failure is when the heart can’t pump blood the way it should. In children, it's usually because of a heart problem they were born with (a congenital heart defect).

Before placing the device, doctors try medicines, pacemakers (implanted devices that help control the heartbeat), and other treatments.

What Are the Different Types of Ventricular Assist Devices?

There are two main types of ventricular assist devices. The type someone needs depends on which ventricle is damaged:

Someone with a damaged left ventricle needs a left ventricular assist device (LVAD). The LVAD pumps blood from the left ventricle to the aorta and out to the body.
Someone with a damaged right ventricle needs a right ventricular assist device (RVAD). The RVAD pumps blood from the right atrium to the pulmonary arteries and out to the lungs.

Each device connects to a rechargeable battery and controller outside the body.

In rare cases, a person might need a VAD for the left and right ventricles both, called a biventricular assist device (biVAD).

How Is a Ventricular Assist Device Placed?

A surgeon places the device during open-heart surgery. For this procedure:

The patient gets general anesthesia to sleep through the surgery and not feel pain.
The surgeon makes an incision (cut) in the skin, then places the pump unit near the heart and connects it to a cable. The cable goes to a controller (small computer) outside the body.
The surgeon connects the pump unit to two tubes. One tube drains blood to the pump, and the other delivers the blood from the pump to either the aorta (for LVAD) or the pulmonary artery (for RVAD).

Sometimes the surgeon uses a heart-lung bypass machine during surgery to take over the work of the heart and lungs.

Most people stay in the hospital for a few weeks after they get a ventricular assist device.

How Is a Ventricular Assist Device Removed?

When the device is no longer needed, the surgeon removes it with another open-heart surgery while the patient is under general anesthesia.

What Are the Risks of a Ventricular Assist Device?

There are risks with every surgery. Your child’s surgeon will go over all risks in detail. These can include:

infection
blood clots and stroke
bleeding
kidney injury

How Can Parents Help?

Children with a ventricular assist device will have many follow-up doctor visits. This might feel overwhelming at times. The doctors, nurses, social workers, and other members of the care team are there for you and your child. Talk to any of them about resources that can help your family.

To help your child:

Go to all medical visits.
Give all medicines as prescribed.
Follow your surgeon’s instructions for:
- how to use the ventricular assist device’s controller
- home care, such as weight and blood pressure checks
- any activities your child should not do
Be sure the school nurse knows about your child’s ventricular assist device.
Talk to the school staff about any accommodations your child may need, such as the use of an elevator or a reduced academic load.
Find activities that are fun and safe for your child. Have other kids join in so your child feels connected to others.