What is a Ventricular Assist Device?
A Ventricular Assist Device, or VAD, is a mechanical circulatory device that is used in patients with advanced heart failure to partially or completely replace the functioning of the failing heart, and thereby, improving the blood flow to the rest of the body. There are various types of VAD pumps of which some may be implanted in your body or connected to the outside of your body. Furthermore, some VADs are intended for short term use, while others are intended for long term use.
A left ventricular assist device (LVAD), the most commonly used VAD, supports the pumping action of the left ventricle; a right ventricular assist device (RVAD) supports the function of the right ventricle; and a biventricular assist device (BiVAD) supports the function of both the right and left ventricle. There are various types of indication for VAD therapy which is based on the type of heart failure, other illnesses that may be affecting the patient, and the ultimate goal of treatment.
The three general categories of VAD therapy include:
- Bridge to Decision (BTD) in which a VAD is implanted to support an acutely failing heart, and thereby, immediately stabilizing the patient and allowing time for the health care team to gather all the necessary information to provide the patient and family with the optimal long-term treatment option.
- In the second category, Bridge to Transplant (BTT), a VAD is implanted in patients who are awaiting a cardiac transplant but becoming more ill as a result of progressive heart failure. BTT VADs optimize the patient’s condition and quality of life during the time they wait for the most suitable donor heart.
- The final category, Destination Therapy (DT), a VAD is implanted with the treatment goal of long-term cardiac support in individuals who do not qualify for a cardiac transplantation.