How Ventricular Assist Devices Can Help Your Heart

“Above all else, guard your heart, for everything you do flows from it.”

-Proverbs 4:23

Our heartbeats are the soundtrack of our lives, always beating, always keeping time. Our hearts are at the center of everything we do. But sometimes, certain health conditions can mean our hearts need a little help to keep beating strong.

Over 6 million Americans are living with heart failure, with 10% having advanced heart failure. If you or a loved one is experiencing this, we know the physical and emotional impact it can have on your lives, but you aren’t alone. At the AdventHealth Transplant Institute, we’re the only institution in Central Florida that offers a ventricular assist device (VAD) program dedicated to your needs.

Keep reading to learn from Pujan P. Patel, MD, advanced heart failure and heart transplant cardiologist, as well as AdventHealth Transplant Institute VAD Program Medical Director, on what you need to know about treating advanced heart failure with VADs and how you can find new hope.

Understanding Advanced Heart Failure

“Advanced heart failure is when regular treatments and symptom management no longer work to treat heart failure,” says Dr. Patel. Heart failure worsens over time, resulting in the heart pumping less blood, with more severe symptoms developing over time.

“Although there’s no cure for advanced heart failure, there are still ways to treat it,” says Dr. Patel. For some, a combination of medications and lifestyle changes may help manage their symptoms. However, more advanced treatment, like implanting a ventricular assist device (VAD), is required for others.

What Is a Ventricular Assist Device (VAD)?

A VAD is an artificial device that helps your heart pump blood properly. “It works by pumping blood from the lower chambers of the heart, reducing its workload and benefiting overall circulation,” says Dr. Patel.

VADs are typically implanted in the lower left ventricle of the heart, known as a left ventricular assist device, or LVAD. Other VAD devices include RVADs, which are placed on the right ventricle and BiVADs, which support both ventricles. Ventricular assist devices are good options for those who aren’t qualified for a heart transplant.

The Nuts and Bolts of Ventricular Assist Devices

There are six components of a VAD device. Some stay inside the body, while others remain outside. The components include:

• Controller: The controller is an external piece of the device that helps you and your health care provider monitor VAD functioning and works as the central hub for the device.
• Driveline: The driveline is the cord that connects the controller to the VAD, running through your skin.
• External battery pack: This device's main power source is a battery pack. It includes a backup power supply in case something happens, and the controller connects the battery to the VAD.
• Inflow cannula: This tube connects the VAD pump to the tip of the ventricle to draw blood from the heart to the pump.
• Mechanical pump: The central piece of the VAD device is the pump that controls the heart’s pumping action.
• Outflow cannula: With every beat, the outflow cannula carries the blood from the heart to the aorta, allowing for proper blood circulation to the rest of the body.

These six components work harmoniously to improve blood flow and circulation to the body.

How the VAD Procedure Works

“This procedure requires open-heart surgery,” says Dr. Patel. “Once you’re under anesthesia and the breathing tube is in place, your surgeon makes an incision in the middle of the chest and opens the sac around your heart.”

This procedure requires surgeons to stop the heart for safety and proper placement of the VAD. Your surgical team will put you on a heart-lung bypass machine to keep oxygen-rich blood circulating in your body.

“We then insert the VAD into the proper area of the heart,” says Dr. Patel. The surgeon places the inflow and outflow cannula in their proper place and inserts the driveline from the VAD through the abdominal wall.

“Once everything is properly placed, we turn on the VAD and slowly increase its power while weaning the patient off the bypass machine until the VAD is in full control,” says Dr. Patel.

What Are the Risks of VAD Procedures?

Just like any surgical procedure, there are risks associated with VADs, including:

• Arrhythmias
• Bleeding
• Blood clots
• Infection
• Device malfunction
• Right-sided heart failure
• Stroke

It’s vital that you talk to your doctor and cardiologist to ensure this procedure is right for you and your health needs.

Benefits, Qualifications and Candidacy for VAD Procedures

A ventricular assist device has many benefits, including improved quality of life, increased energy, better organ function and the potential to extend a patient's life span. However, these devices aren’t for everyone. “Patients must meet specific qualifications to be considered for candidacy,” says Dr. Patel.

“Only those with advanced heart failure can receive a VAD. Refractory symptoms, or symptoms that severely limit a person’s physical activity despite medical management, are another qualification we look for,” says Dr. Patel. The final qualification for VAD procedures is the patient remaining nonresponsive to other treatment options. If a patient meets these qualifications, they’re a good candidate for a VAD procedure. At the AdventHealth Transplant Institute, we work with you and your cardiologist to determine if a VAD is the right advanced therapy for you.

World-Renowned Experts in Matters of the Heart

“We’re honored to be the highest volume institution in Central Florida that offers a VAD program, and we recently celebrated our 500^th VAD procedure at the AdventHealth Transplant Institute,” says Dr. Patel. “It’s truly been an honor serving as the program's medical director and offering a new sense of hope to those experiencing a heart failure diagnosis.” At the AdventHealth Transplant Institute, we’re leading the way toward heart care expertise and patient satisfaction through forward-thinking and world-class care.

Helping Your Heart Stay on Beat

When it comes to matters of the heart, we know you want the highest level of care. That’s why we’re honored to provide you with world-renowned care at the AdventHealth Transplant Institute. We understand how overwhelming a heart failure diagnosis can be for you and your loved ones, but you aren’t alone. We’re here by your side and promise to walk with you every step of the way.

Visit us here to learn more about our VAD program, and contact us with any questions. You deserve compassionate, whole-person care.