Who Can Benefit from Ventricular Assist Devices
If your heart becomes too weak to respond to medical therapies, you may benefit from a ventricular assist device (VAD).
Ventricular assist devices (VADs) are small pumps which are implanted in the chest/upper abdomen which take over the pumping function for a failing heart. The VAD allows the person to recover from their heart failure, undergo rehabilitation, and be discharged from the hospital.
Overall survival, as well as functional capacity, and quality of life also improve substantially after VAD implantation. Patients may be referred for a VAD as a bridge to transplantation, a bridge to recovery, or as destination therapy.
Bridge to Transplantation
Each year, more patients with end-stage heart failure are evaluated and listed for transplantation. Unfortunately, there are not enough suitable donor organs for all the patients awaiting transplantation.
Patients who are listed for transplantation and are too ill to wait any longer, or who are expected to have prolonged wait times are referred for a VAD as a bridge to transplantation. The VAD allows them to recover and wait at home for an organ to become available.
Bridge to Recovery
In some cases of heart failure, particularly newly diagnosed heart failure or heart failure after other cardiac surgery, the heart may recover after a period of support on a VAD. These patients are supported temporarily as a bridge to recovery.
After implantation, the VAD is turned down and the heart is reassessed to see if its function has improved enough to allow the VAD to be removed.
Typically, people recommended for VAD used as a bridge to recovery have heart failure as a result of:
- Viral infection (myocarditis)
- Childbirth (postpartum cardiomyopathy)
- A heart attack
- Another cause of heart disease that has not responded to medical therapy
There is a growing population of patients who have end-stage heart failure, but are not candidates for heart transplantation usually due to age or other chronic medical problems.
These patients may be referred for a VAD as an alternative to heart transplantation. This is known as destination therapy.
For end-stage heart failure patients who are not eligible for heart transplantation, destination VAD therapy:
- Improves survival
- Enhances functional status and quality of life
- Allows for years of support
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