Table of ContentsView AllTable of ContentsFunctionsVAD vs. PacemakersComplexity of SurgeryPostop Life ExpectancyLife With LVADCaretaker Support
Table of ContentsView All
View All
Table of Contents
Functions
VAD vs. Pacemakers
Complexity of Surgery
Postop Life Expectancy
Life With LVAD
Caretaker Support
A ventricular assist device (VAD) is a mechanical pump implanted in the heart to help the heart pump blood throughout the body. Healthcare providers use it as a treatment in people with severe (stage D) heart failure who are waiting for a heart transplant or when a transplant is not an option.
Stage D heart failure is the most serious type, resulting in impaired blood flow—despite interventions—and significantly impacting quality of life. When a person reaches stage D heart failure, there are only a few treatment options, such as a heart transplant or a ventricular assist device.
Functions of Ventricular Assist Devices
Healthcare providers use VADs when treatments are no longer effective in controllingheart failuresymptoms. A VAD is a mechanical heart pump that can relieve symptoms associated withadvanced heart failure, but it does have risks, such as infection, stroke, and bleeding.A VAD is a motorized pump a specialized surgeon implants into the tip of the heart to act as one or both ventricles or lower heart chambers. It has a power cord—the driveline cord—that connects the VAD to an external controller. The driveline cord usually exits the body through a surgical opening, called a driveline site, often in the abdominal area.
The driveline cord connects to a controller box that most people with VADs wear on a belt around their waist. The controller box operates the pump, monitors for problems with the VAD, and sends alerts and alarms if any issues arise. The controller is connected to a portable battery pack or an electrical cable plugged into an outlet.
Left VAD
The most common type of VAD is aleft ventricular assist device(LVAD) used to support the heart’s left ventricle function.The heart’s left ventricle pumps nutrient- and oxygen-rich blood out of the heart and into the body.
Right VAD
Right ventricular assist devices are less common but are often considered a lifesaving option.The heart’s right ventricle pumps blood from the heart into the lungs to oxygenate the blood.
VADs are recommended to patients who have severe heart failure either as a bridge to heart transplantation or as destination therapy. While a ventricular assist device can improve heart failure symptoms, important lifestyle adjustments must also be made.—CHRISTOPHER LEE, MD, MEDICAL EXPERT BOARD
VADs are recommended to patients who have severe heart failure either as a bridge to heart transplantation or as destination therapy. While a ventricular assist device can improve heart failure symptoms, important lifestyle adjustments must also be made.
—CHRISTOPHER LEE, MD, MEDICAL EXPERT BOARD
All Parts of Heart Anatomy
VADs vs. Pacemakers
The VAD and pacemaker are both implanted devices, but have some key differences:
VAD
A VAD is a mechanical pump designed to keep one or both of the heart’s ventricles working.It is used when the heart becomes too weak to pump blood effectively and is often the last treatment option before a heart transplant. In some cases, the VAD works well enough to eliminate the need for a heart transplant.
Pacemaker
Apacemakeris an implantable device to help regulate the heart’s electrical system.A healthcare provider may opt for a pacemaker to help conduct electrical impulses in the heart and keep it beating regularly if the heart’s sinoatrial node (natural pacemaker) is damaged or not working correctly.
VAD surgery is a type of open-heart surgery that typically takes between four and six hours. During the surgery, you can expect the following:
VAD Surgery RisksOpen heart surgery is a complex operation which has risks such as:BleedingInfectionPotential for additional surgeryStroke
VAD Surgery Risks
Open heart surgery is a complex operation which has risks such as:BleedingInfectionPotential for additional surgeryStroke
Open heart surgery is a complex operation which has risks such as:
Life Expectancy After Surgery
Healthcare providers initially intended to use VADs as a short-term treatment for severe heart failure until a viable heart was available for transplant.
However, with a lack of available hearts for transplant, people with stage D heart failure depend on VADs for much longer than initially intended. A 2020 study found that long-term survival with VAD is as high as 51% at the seven-year point, which supports the long-term use of VADs as an appropriate treatment option for severe heart failure.
VAD and Comorbid ConditionsThe vast majority of people who undergo a VAD surgery have co-occurring, or comorbid, conditions, the most common of which include:Chronic kidney diseaseDiabetesOverweight or experiencing obesityPulmonary hypertension
VAD and Comorbid Conditions
The vast majority of people who undergo a VAD surgery have co-occurring, or comorbid, conditions, the most common of which include:Chronic kidney diseaseDiabetesOverweight or experiencing obesityPulmonary hypertension
The vast majority of people who undergo a VAD surgery have co-occurring, or comorbid, conditions, the most common of which include:
After recovering from VAD surgery, people often express relief from weakness, tiredness, and shortness of breath associated with heart failure. Usually, they can perform theiractivities of daily livingmuch more easily than before surgery. As recovery progresses, some people can return to work or travel, something they lacked the energy and physical ability to do before the VAD surgery.
A VAD can impact your life in a positive way, but there are certain adjustments to consider.
Consistent Power Access
A VAD is a mechanical pump that requires power to operate. Its battery packs allow mobility and last up to 17 hours. You should plug the battery packs into an electrical outlet while you sleep so they can recharge.
Driveline Care
The VAD is implanted near the heart but has a power cable that exits the body to connect to a power source. The driveline site requires proper cleaning and special bandages to prevent infection.
Regular Medication Checks
People with VADs need to take blood thinners to prevent blood clots. People taking blood thinners require regular checkups with a healthcare provider.
Contact With Water
Once a VAD is placed, you cannot submerge yourself in water due to the power supply and driveline site. You can use protective devices for the power source while you shower, but you cannot bathe or swim.
Emotional Challenges
Many people with a VAD appreciate experiencing an improvement in how they feel and performing normal activities of daily living. However, caring for the VAD and adapting your lifestyle to accommodate the VAD can cause feelings of anxiety, worry, or stress.
Sex Life Changes
Generally, it is safe to have sex once you have recovered from surgery. But living with a VAD might change your sex life. It is important to share any sex life concerns with your sexual partner(s) and talk to a healthcare provider.
Costs Associated With VADVAD surgery can cost around $175,000, depending on hospital and professional costs and any additional testing required.Medicare and Medicaid and most commercial insurance carriers cover VAD surgery costs.If you do not have insurance, nonprofit hospitals must provide financial assistance to eligible patients who cannot afford the medical costs.It is important you work with your insurance provider and/or the hospital where you will be receiving VAD surgery to be fully informed about the associated costs and your potential out-of-pocket expenses.
Costs Associated With VAD
VAD surgery can cost around $175,000, depending on hospital and professional costs and any additional testing required.Medicare and Medicaid and most commercial insurance carriers cover VAD surgery costs.If you do not have insurance, nonprofit hospitals must provide financial assistance to eligible patients who cannot afford the medical costs.It is important you work with your insurance provider and/or the hospital where you will be receiving VAD surgery to be fully informed about the associated costs and your potential out-of-pocket expenses.
VAD surgery can cost around $175,000, depending on hospital and professional costs and any additional testing required.Medicare and Medicaid and most commercial insurance carriers cover VAD surgery costs.
If you do not have insurance, nonprofit hospitals must provide financial assistance to eligible patients who cannot afford the medical costs.It is important you work with your insurance provider and/or the hospital where you will be receiving VAD surgery to be fully informed about the associated costs and your potential out-of-pocket expenses.
When determining eligibility for VAD surgery, healthcare providers consider whether the individual has access to a reliable caregiver. Recovery from VAD surgery can require minimal to significant support. As part of the VAD process, healthcare providers encourage caregivers to participate in preoperative and postoperative education. Caregiver support is crucial to long-term recovery for people living with VADs.
Summary
A ventricular assist device (VAD) is a treatment option for people with stage D heart failure. It is a mechanical pump that performs the functions of the left or right ventricles of the heart. Healthcare providers initially intended to use VADs as a short-term option for people awaiting a heart transplant. Still, because of the lack of available hearts for transplant, VADs can be used for long-term treatment of heart failure as well.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chaudhry S, DeVore AD, Vidula H, et al.Left ventricular assist devices: a primer for the general cardiologist.JAHA. 2022;11(24):e027251. doi.org/10.1161/JAHA.122.027251American Heart Association.Recognizing advanced heart failure and knowing your options.MedlinePlus.Ventricular assist device.Abdelshafy M, Caliskan K, Guven G, et al.Temporary right-ventricular assist devices: a systematic review.J Clin Med. 2022;11(3):613. 2022. doi:10.3390/jcm11030613American Heart Association.Implantable medical devices.National Heart, Lung and Blood Institute.Heart surgery - What to expect.Colorado Program for Patient Centered Decisions.Left ventricular assist device.Zimpfer D, Fiane AE, Larbalestier R, et al.Long-term survival of patients with advanced heart failure receiving an left ventricular assist device intended as a bridge to transplantation: the registry to evaluate the heartware left ventricular assist system.Circ: Heart Failure. 2020;13(3):e006252. doi.org/10.1161/CIRCHEARTFAILURE.119.006252Warraich HJ, Allen LA, Blue LJ, et al.Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation: an analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End-Stage Heart Failure (DECIDE-LVAD) study.Am Heart J. 2019;213:91-96. doi:10.1016/j.ahj.2019.04.008.Cascino TM, Kittleson MM, Lala A, et al.Comorbid conditions and health-related quality of life in ambulatory heart failure patients: revival (registry evaluation of vital information for VADs in ambulatory life revival).Circ: Heart Failure. 2020;13(5):e006858. doi.org/10.1161/CIRCHEARTFAILURE.119.006858British Heart Foundation.Focus on: left ventricular assist devices.Baras Shreibati J, Goldhaber-Fiebert JD, Banerjee D, Owens DK, Hlatky MA.Cost-effectiveness of left ventricular assist devices in ambulatory patients with advanced heart failure.JACC: Heart Failure. 2017;5(2):110-119. doi.org/10.1016/j.jchf.2016.09.008Centers for Medicare and Medicaid Services.Ventricular assist devices.Centers for Medicare and Medicaid Services.How to apply for financial assistance.Colorado Program for Patient Centered Decisions.Charting your course: a guide for caregivers of people living with LVADs.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chaudhry S, DeVore AD, Vidula H, et al.Left ventricular assist devices: a primer for the general cardiologist.JAHA. 2022;11(24):e027251. doi.org/10.1161/JAHA.122.027251American Heart Association.Recognizing advanced heart failure and knowing your options.MedlinePlus.Ventricular assist device.Abdelshafy M, Caliskan K, Guven G, et al.Temporary right-ventricular assist devices: a systematic review.J Clin Med. 2022;11(3):613. 2022. doi:10.3390/jcm11030613American Heart Association.Implantable medical devices.National Heart, Lung and Blood Institute.Heart surgery - What to expect.Colorado Program for Patient Centered Decisions.Left ventricular assist device.Zimpfer D, Fiane AE, Larbalestier R, et al.Long-term survival of patients with advanced heart failure receiving an left ventricular assist device intended as a bridge to transplantation: the registry to evaluate the heartware left ventricular assist system.Circ: Heart Failure. 2020;13(3):e006252. doi.org/10.1161/CIRCHEARTFAILURE.119.006252Warraich HJ, Allen LA, Blue LJ, et al.Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation: an analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End-Stage Heart Failure (DECIDE-LVAD) study.Am Heart J. 2019;213:91-96. doi:10.1016/j.ahj.2019.04.008.Cascino TM, Kittleson MM, Lala A, et al.Comorbid conditions and health-related quality of life in ambulatory heart failure patients: revival (registry evaluation of vital information for VADs in ambulatory life revival).Circ: Heart Failure. 2020;13(5):e006858. doi.org/10.1161/CIRCHEARTFAILURE.119.006858British Heart Foundation.Focus on: left ventricular assist devices.Baras Shreibati J, Goldhaber-Fiebert JD, Banerjee D, Owens DK, Hlatky MA.Cost-effectiveness of left ventricular assist devices in ambulatory patients with advanced heart failure.JACC: Heart Failure. 2017;5(2):110-119. doi.org/10.1016/j.jchf.2016.09.008Centers for Medicare and Medicaid Services.Ventricular assist devices.Centers for Medicare and Medicaid Services.How to apply for financial assistance.Colorado Program for Patient Centered Decisions.Charting your course: a guide for caregivers of people living with LVADs.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Chaudhry S, DeVore AD, Vidula H, et al.Left ventricular assist devices: a primer for the general cardiologist.JAHA. 2022;11(24):e027251. doi.org/10.1161/JAHA.122.027251American Heart Association.Recognizing advanced heart failure and knowing your options.MedlinePlus.Ventricular assist device.Abdelshafy M, Caliskan K, Guven G, et al.Temporary right-ventricular assist devices: a systematic review.J Clin Med. 2022;11(3):613. 2022. doi:10.3390/jcm11030613American Heart Association.Implantable medical devices.National Heart, Lung and Blood Institute.Heart surgery - What to expect.Colorado Program for Patient Centered Decisions.Left ventricular assist device.Zimpfer D, Fiane AE, Larbalestier R, et al.Long-term survival of patients with advanced heart failure receiving an left ventricular assist device intended as a bridge to transplantation: the registry to evaluate the heartware left ventricular assist system.Circ: Heart Failure. 2020;13(3):e006252. doi.org/10.1161/CIRCHEARTFAILURE.119.006252Warraich HJ, Allen LA, Blue LJ, et al.Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation: an analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End-Stage Heart Failure (DECIDE-LVAD) study.Am Heart J. 2019;213:91-96. doi:10.1016/j.ahj.2019.04.008.Cascino TM, Kittleson MM, Lala A, et al.Comorbid conditions and health-related quality of life in ambulatory heart failure patients: revival (registry evaluation of vital information for VADs in ambulatory life revival).Circ: Heart Failure. 2020;13(5):e006858. doi.org/10.1161/CIRCHEARTFAILURE.119.006858British Heart Foundation.Focus on: left ventricular assist devices.Baras Shreibati J, Goldhaber-Fiebert JD, Banerjee D, Owens DK, Hlatky MA.Cost-effectiveness of left ventricular assist devices in ambulatory patients with advanced heart failure.JACC: Heart Failure. 2017;5(2):110-119. doi.org/10.1016/j.jchf.2016.09.008Centers for Medicare and Medicaid Services.Ventricular assist devices.Centers for Medicare and Medicaid Services.How to apply for financial assistance.Colorado Program for Patient Centered Decisions.Charting your course: a guide for caregivers of people living with LVADs.
Chaudhry S, DeVore AD, Vidula H, et al.Left ventricular assist devices: a primer for the general cardiologist.JAHA. 2022;11(24):e027251. doi.org/10.1161/JAHA.122.027251
American Heart Association.Recognizing advanced heart failure and knowing your options.
MedlinePlus.Ventricular assist device.
Abdelshafy M, Caliskan K, Guven G, et al.Temporary right-ventricular assist devices: a systematic review.J Clin Med. 2022;11(3):613. 2022. doi:10.3390/jcm11030613
American Heart Association.Implantable medical devices.
National Heart, Lung and Blood Institute.Heart surgery - What to expect.
Colorado Program for Patient Centered Decisions.Left ventricular assist device.
Zimpfer D, Fiane AE, Larbalestier R, et al.Long-term survival of patients with advanced heart failure receiving an left ventricular assist device intended as a bridge to transplantation: the registry to evaluate the heartware left ventricular assist system.Circ: Heart Failure. 2020;13(3):e006252. doi.org/10.1161/CIRCHEARTFAILURE.119.006252
Warraich HJ, Allen LA, Blue LJ, et al.Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation: an analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End-Stage Heart Failure (DECIDE-LVAD) study.Am Heart J. 2019;213:91-96. doi:10.1016/j.ahj.2019.04.008.
Cascino TM, Kittleson MM, Lala A, et al.Comorbid conditions and health-related quality of life in ambulatory heart failure patients: revival (registry evaluation of vital information for VADs in ambulatory life revival).Circ: Heart Failure. 2020;13(5):e006858. doi.org/10.1161/CIRCHEARTFAILURE.119.006858
British Heart Foundation.Focus on: left ventricular assist devices.
Baras Shreibati J, Goldhaber-Fiebert JD, Banerjee D, Owens DK, Hlatky MA.Cost-effectiveness of left ventricular assist devices in ambulatory patients with advanced heart failure.JACC: Heart Failure. 2017;5(2):110-119. doi.org/10.1016/j.jchf.2016.09.008
Centers for Medicare and Medicaid Services.Ventricular assist devices.
Centers for Medicare and Medicaid Services.How to apply for financial assistance.
Colorado Program for Patient Centered Decisions.Charting your course: a guide for caregivers of people living with LVADs.
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