Ventricular Assist Devices

Abstract

Heart failure is the final common pathway for many chronic heart diseases. With the aging of the population and advances in the treatment of cardiac disease, the number of patients with heart failure continues to increase. Although the majority of patients will remain stable for several years with standard medicines and surgery, a growing number will develop symptoms of advanced heart failure and may be referred for evaluation for heart transplant. For selected patients who are too ill to wait for a heart donor or who are not eligible for a heart transplant because of age or other medical problems, ventricular assist devices (VADs) offer life-saving therapy. Initially designed as temporary support to bridge patients to heart transplant, these devices are now available and increasingly being used as lifetime support or destination therapy. Improvements in device design, along with advances in surgical and medical management, have allowed VAD patients to return home, to work, and to their communities, with excellent quality of life. At the same time, however, unique challenges have been encountered. This Cardiology Patient Page will discuss the fundamentals of VADs, including patient selection, pump design, surgical and medical treatment, expected benefits and long-term risks, and the team approach to care. Heart failure is a common cardiac condition in which the heart is unable to pump blood at a sufficient rate to meet the demands of the body. There are 2 major types of heart failure: one is associated with abnormal heart filling (sometimes called diastolic heart failure or heart failure with preserved ejection fraction), and the other is associated with abnormal heart emptying (also called systolic heart failure or heart failure with reduced ejection fraction). Most patients who develop heart failure have had a prior injury or stress on the heart that caused the heart to weaken. …