What is a VAD?

A ventricular assist device (VAD) is a pump that is put into a poorly pumping heart during a surgery. It helps the heart to pump blood through the body. A VAD is put in to help organs get better and improve heart failure symptoms in children (symptoms like shortness of breath, tiredness, swelling, trouble gaining weight). 

 

Why is a VAD used?

A VAD may be used to help a heart pump for many reasons. 

  • Bridge to transplant  To support the heart until a heart transplant can happen.
  • Destination therapy – To support the heart for the rest of someone’s life if transplantation is not the right option for the patient.
  • Bridge to recovery To support the heart if there is a chance the heart will recover.
  • Bridge to decision To support the heart until a decision can be made by the family and medical team regarding next steps (surgeries or medications). 

 

Understanding terminology

VADs can be described by:

  • Device location – Where they are put in the heart
    A VAD can be used to help the left (LVAD), right (RVAD) or both ventricles (BiVAD) pump. 
  • Flow Type – How they pump 
    VADs can pump blood by a spinning action (continuous flow VAD) or by a pumping action (pulsatile flow VAD).
  • Duration – How long they are usually used
    VADs can be used for short or long times.  VADs made to be used for shorter time periods are sometimes called “temporary” VADs.  VADs made to be used for long periods are sometimes called “durable” VADs.

 

Pediatric life with a VAD

Children may need a VAD because they are born with a heart problem or because one develops with time. Children with heart failure often have symptoms like feeling short of breath, trouble eating or gaining weight, and low energy.  A VAD may help these symptoms get better. 

While, VADs have been shown to help many patients, living with a VAD has its challenges. VAD patients must:

  • take blood thinners and other medicines to help the heart
  • have frequent visits to the doctor to make sure the VAD is working right
  • have a 24-hour caregiver who understands how the pump works
  • change the bandages and clean the area where parts of the pump come
    through the skin

 

Devices 

Different pumps may be used for a child depending on his/her size. There is only one FDA approved VAD for children (the Berlin Heart EXCOR). However, there are some VADs made for adults that are small enough for some children. Below is the list of the VADs most commonly used in children. 

For more information on these devices, please review our Patients & Families Resources.

Devices where the pump sits outside the body – Paracorporeal Devices
The pump sits outside the body. The blood flows out the body, through the pump and back into the body through tubes (cannulas). These are typically utilized in smaller patients. Patients must remain the hospital with these devices because of the special care and monitoring that is required. 

Berlin Heart EXCOR

The Berlin Heart EXCOR is the only FDA approved VAD. It pumps blood forward using an air-filled machine. Tubes (cannulas) are placed inside the heart, bring blood out of the body through the pump, and then pump it back to the body. The VAD sits outside of the body near the stomach.  There are many different pump sizes that can support babies up through adults. This VAD is usually for patients who will get a heart transplant.    

CentriMag, PediMag, & Rotaflow

The CentriMag, PediMag™, and Rotaflow are VADs that pump blood by spinning and propelling blood forward. Tubes (cannulas) are placed inside the heart, bring blood out of the body through the pump, and then pushed back through the body. The pump usually sits next to the hospital bed and patient. These pumps were originally made to be used for short periods of time (hours to days). They are now being used for longer periods (days to months). These devices can be used for patients who may recover or who will get a heart transplant

Devices where the pump sits inside the body – Intracorporeal Devices

The pump is placed in the heart and helps to pump blood through the body. There are lines that stick out of the body to give power to the pump and help control the pump. Patients may stay in the hospital or go home depending on how they are doing.  

HeartWare Ventricular Assist Device (HVAD)

The Heartware HVAD pumps blood by spinning and propelling blood forward. It is pulls blood out of the heart and pushes it back out to the body.  The blood does not leave the body.  There is an electrical cord that comes out of the skin and gives the pump power and controls how it works. The device can fit in large children, teenagers, and adults. It can be used for patients who will get a heart transplant or in some patients who will not get a heart transplant. The HVAD is not FDA-approved for pediatric use.

HeartMate II and HeartMate 3 VAD

The HeartMate II and HeartMate 3VADs pump blood by spinning and propelling blood forward. They pull blood out of the heart and pushes it back out to the body. The blood does not leave the body. There is an electrical cord that comes out of the skin and gives the pump power and controls how it works. The devices can fit in large children, teenagers, and adults. They can be used for patients who will get a heart transplant or in some patients who will not get a heart transplant.

SynCardia Total Artificial Heart

The SynCardia TAH is different from VADs because it is pulsatile and replaces the lower chambers of the heart (ventricles) and the four valves. The surgeon puts the TAH in the place where the ventricles used to be. The TAH pumps blood to both the lungs and body. Two tubes come out of the skin and connect to an external machine called a driver. The driver supplies pulses of air to pump blood in and out of the TAH. The TAH can fit in some larger children, teenagers and adults. This device is used for patients who will get a heart transplant.