Who says a heart has to go “thump”? Why not “whizzz”? A new generation of artificial hearts does just that. Today’s continuous flow ventricular assist devices (or VADs) have emerged as one of the few effective treatments for heart failure. They offer hope to late-stage patients who cannot receive or access a transplantable donor heart.
The VAD is a little circular pump powered by an electric motor. The swollen part houses a bladed wheel that whooshes the blood out of the heart to circulate throughout the body. It takes a load off of whichever ventricle it’s attached to (usually the left), and gives the failing heart muscle an opportunity to rest, recuperate or retire.
External and internal heart assist devices have come in many shapes and sizes over the years. Each generation gets more compact. Today’s continuous flow VAD is small enough to lie on the flat of your hand. In appearance, it resembles a swollen drain pipe, with flexible tubes angling out of either end. The device is implanted into the chest through open heart surgery. One of the flexible tubes is inserted into a ventricle through the bottom of the heart. The other tube goes into the great vessel at the top of the heart. When the VAD is turned on, a circular motor pumps blood through the body with a gentle “whizzz.” It is powered by an external battery connected by a cord emerging from a permanent incision.
VADs were first used as what they call a “bridge to transplant.” That is, they were implanted to keep heart failure patients alive while they waited for a donor heart to become available. But now, they’re increasingly being used as a destination therapy – that is, a permanent alternative to a transplanted heart for patients with late-stage heart failure.
A VAD is not as tidy a solution as that still-elusive Holy Grail: the totally-implantable artificial heart. But their successful use as a destination therapy shows how far medical innovation has come in treating some of our most intractable disease conditions.
“Gone are the days when patients had a long-term stay in the hospital after an LVAD placement,” says Maria Mountis, DO, of Cardiovascular Medicine. “Many patients are now discharged home within two weeks following surgery and fully involved in family activities and their daily routines. They are participating in cardiac rehab and returning to work within a few months.”
Innovators at Cleveland Clinic have helped pioneer the development of VADs over the past 20 years. Today, surgeons at Cleveland Clinic have access to more different types of VADs and more experience in their implantation and follow-up than any center in the nation. The combination of technology, expertise and experience allows Cleveland Clinic to personalize care to heart failure patients and provide the full spectrum of treatments for this difficult condition.