Ventricular Assist Device Program

The Seton Ventricular Assist Device (VAD) Program provides and coordinates services for patients with chronic Heart Failure in an effort to promote optimal health, improve quality of life and provide comprehensive outpatient services.

Patients served by the VAD Program have been diagnosed with Heart Failure, Cardiomyopathy, Chronic Ischemic Heart Disease, and Adult Congenital Heart Disease, and did not respond to conventional therapies.

The staff of Seton’s VAD Program provides various services, including:

• Patient Education – Medication, Diet and Activity
• Health Monitoring
• Symptom Management
• Case Management
• Clinic Follow-Up
• Telephone Management
• Access to Cardiologists Specializing in Heart Failure and Transplant
• Access to Surgeons Specializing in Mechanical Circulatory Support Devices
• Access to Transplant Coordinators Specializing in Circulatory Support Devices.

What to Expect

Patients will have an interview and assessment to determine their conditions. The interview will include education about the clinic process with specific focus on origin of the disease, patient responsibilities, treatment medications and more.

The assessment also will include a physical evaluation of vital signs - weight, blood pressure, heart rate, respirations, temperature and pulse oximetry; a review of medical history and medical records, as available; current medications; allergies; and a functional assessment to determine the patient’s activity scale and quality of life.

Reassessments are based upon patient need and condition at the time of each physician or nurse clinic visit.

What is a VAD?

A Ventricular Assist Device (VAD) is implanted surgically and provides partial or total circulatory assistance to the natural heart.

Types of VADs

The three FDA-approved VADs that are commonly used include the XVEHeartmate® and the Thoratec®, manufactured by Thoratec Laboratories, Inc.; and the Abiomed® BVS 5000, manufactured by Abiomed.

The Heartmate® is a left ventricular assist device (LVAD) that assists or completely takes over the work of the left ventricle. The Heartmate has two tubes connected to an electronic pump, an electronic controller and an energy supply. One tube goes into the left ventricle, pulling blood from the ventricle into the pump. The pump then sends blood into the aorta, the large blood vessel, leaving the ventricle and effectively bypassing the weakened ventricle. The patient will be required to take aspirin daily and will have the option to be considered a home candidate.

The Thoratec® VAD is a versatile unit in that it can provide support to the left side of the heart (LVAD), the right side of the heart (RVAD) or both sides (BIVAD). Patients on this device will require low dose Heparin or Coumadin. The Thoratec portable driver has recently been FDA-approved for home use.

The Abiomed®  BVS5000 is used for temporary left, right or biventricular support in patients with potentially reversible Heart Failure. This air-driven pump is outside the body and powered by electricity. It may be used as a bridge to another device or as a bridge to heart transplantation.

VAD as a Bridge to Transplant

Since 1969, VADs have been used as support to sustain a patient’s life and maintain their other organ function while awaiting heart transplantation. Recently, great strides have been made to improve the quality of life for patients on VADs by allowing patients to go home on these devices. VADs also allow waiting-list candidates to improve their overall condition, providing adequate cardiac function for cardiac rehabilitation.

VAD as Part of Support After Cardiac Surgery

The heart muscle needs time to recover after open-heart surgery. The VAD can serve as a device to allow the natural heart to recover.

VAD as Permanent Support (Destination Therapy)

Recently, the Heartmate was approved by the FDA for permanent implantation in certain Heart Failure patients who are on optimal medical therapy, have exhausted all other treatment options and do not meet criteria for heart transplantation.

Complications of VADs

Complications vary with devices, and each device has its own pros and cons. Please discuss your options with your cardiovascular surgeon. Some complications include:

• Bleeding
• Stroke
• Infection
• Device dysfunction