Heart Assist System Implantation Overview

A heart assist system implantation (also called a ventricular assist device, or VAD) is an artificial heart. This single-chamber artificial heart works by compressed air or battery power. The device boosts the function of a failing ventricle.

Left Ventricular Assist Device © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

If you need a VAD, it is because your heart is failing. Most likely, you will be on a list to receive a heart transplant. You may already be in the hospital. Your doctor will do many tests, for example:

• Echocardiogram —size, shape, and motion of the heart are examined using sound waves
• X-ray —uses radiation to take a picture of structures inside the body
• Cardiac Catheterization —to look for coronary artery disease
• Psychological and social system evaluations to make sure you are prepared to manage the device outside of the hospital

Leading up to the procedure, your doctor will instruct you to:

• Avoid eating for 8 hours before the procedure
• Stop taking aspirin or other anti-inflammatory drugs for one week before surgery. You may also need to stop taking blood-thinning medicines, such as:

• Clopidogrel (Plavix)
• Warfarin (Coumadin)

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure

This is open heart surgery. The doctor will make an incision down the length of your breast bone. The breast bone will then be split and separated. You will be placed on a heart-lung machine. This machine will take the place of your heart and lungs during the surgery. The doctor will place the VAD into a pocket on the inside of the abdominal wall. The device will be sewn into your heart. It may also be sewn into your aorta, depending on the type of device.

Immediately After Procedure

You will be in the intensive care unit (ICU). You will be connected to many tubes. The medical staff will monitor you.

How Long Will It Take?

About 4-8 hours

How Much Will It Hurt?

You will have pain from the surgery. Ask your doctor about medicine to help with the pain.

Average Hospital Stay

• 2-5 days in the ICU

• 2-4 weeks in a regular hospital room

Postoperative Care

At Home

When you return home, do the following to help ensure a smooth recovery:

• Stay in contact with the heart center. You may be waiting for a heart transplant.
• Slowly increase your activity. Ask your doctor if you will be able to return to work.
• As prescribed by your doctor, take blood thinners. These will prevent blood clots.
• Be sure to follow your doctor’s instructions. She will tell you:

• How to take care of your VAD
• When to contact the hospital—Make sure that you know how to call your doctor if you have an emergency.

RESOURCES:

American Heart Association
http://www.americanheart.org/

US Food and Drug Administration
http://www.fda.gov/

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca/index_e.html/

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/splash/

References:

HFSA 2006 Comprehensive Heart Failure Practice Guideline

The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) trial. NEJM. 2001 Volume345:1435-1443

Slaughter M, Milano C, Russel S, et al. Advanced heart failure treated with continuous-flow ventricular assist device. N Engl J Med. 2009; DOI:101056/NEJMoa0909938. Available at: http://www.nejm.org .

Implantable ventricular assist device (VAD). Cleveland Clinic website. Available at: http://www.clevelandclinic.org/heartcenter/pub/guide/disease/heartfailure/lvad.htm . Accessed September 4, 2009.

The Michael E. DeBakey Department of Surgery, Baylor College of Medicine website. Available at: http://www.debakeydepartmentofsurgery.org/ . Accessed September 4, 2009.