Often, when family members, loved ones or patients hear the diagnosis of heart failure, the worst comes to mind; it is normal for a person to feel scared, hopeless and concerned about the future. Nearly five million Americans have been diagnosed with HF, and more then 550,000 new cases are diagnosed each year.

The terminology sounds devastating. However, people are living longer and better lives due to improved therapies aimed to slow the progression and symptoms of heart failure.

The diagnosis of HF refers to the inability of the heart to pump enough blood to the body due to damage or injury. Most cases of HF affect the left ventricle— the larger, stronger chamber of the heart that pumps nutrient-rich blood to the body and head. Over time, HF can affect the entire heart.

HF is usually caused by a heart attack or by damage to the heart from long-standing high blood pressure, illness or for reasons that are unknown. Because the heart has experienced some type of permanent damage, the heart muscle weakens and leads to heart failure.

Over the years, heart failure research has maintained that preventive and lifesaving measures, such as lifestyle changes (quitting smoking, eating healthy and exercise), appropriate medications and other therapies (including pacemakers and defibrillators), slow the progression of HF and improve the quality of life for HF patients. After receiving the diagnosis of HF, many patients work with their cardiologists, other physicians, nurses and additional team members to lead very active and long lives.

In many cases, HF does progress despite all of the work that patients, physicians, families and significant others put into treating this chronic illness. In past years, the only treatment option for end stage heart failure was a heart transplant. Every year 50,000 people need a heart transplant in the U.S., and only 2,000 to 2,500 people will get one.

The good news is that new treatment options are emerging for these patients.

Ventricular Assist Devices (VADs)
Ventricular assist devices or VADs are emerging as the newest treatment for heart failure. A VAD assists a failing heart by helping the heart to pump more effectively. It is surgically implanted by a cardiac surgeon. Prior to and after implantation of a VAD, the patient, family members, loved ones, significant others and any other supportive team members receive education and instruction on how to care for the VAD. Patients and family members are interviewed to ensure a support structure exists before VAD implantation.

Currently, VADs are implanted for three reasons in HF patients who no longer respond to medications or have received the maximum benefit from medical/pacemaker therapies.

These indications are:

1. Bridge to transplantation: This patient will have a VAD implanted to help support his/her life until a donor heart becomes available.

2. Bridge to recovery/decision: This patient is recovering from heart surgery and his/her heart is seriously ill. This device helps the heart recover from shock. It is used until a decision is made to transplant immediately or until the heart shows signs of recovery.

3. Destination therapy: This patient will not qualify for a heart transplant because of other illnesses or age. This VAD may improve the patient’s quality of life at the end of his/her life. The Christ Hospital has earned The Joint Commission’s Gold Seal of Approval™ for its Mechanical Heart Assist Device Program. A team of Joint Commission expert surveyors evaluated the hospital for compliance with standards of care specific to the needs of heart failure and LVAD patients and families, including infection prevention and control, leadership and medication management. This certification enables the program to offer destination therapy treatment (DT) with ventricular assist devices (VAD). While The Christ Hospital has been performing VAD implantation for bridge-to-transplant or –decision for more than a year, with this certification it can now also offer DT.
   
   How does the VAD work?
   The VAD pulls blood from the left ventricle and pumps it into the aorta, the large blood vessel/artery that circulates blood to the body and the head. The heart still “beats” and moves in the chest, but the VAD assists the heart in circulating blood to other vital organs.

How does the VAD look once it is implanted?
Most VADs rest close to the bottom of the heart inside the chest. A skinline (the power cable or system driver cable) exits out of the right upper abdomen and will be attached to the system driver, which is about the size of a large wallet, and is strapped around the waist. This system driver is powered either by two lithium batteries that fit in a holster supported by the patient's shoulders, or to a main power/charger box that is plugged into an electrical outlet at home. The two batteries help the patient to remain mobile and to carry on normal activities such as working or shopping for up to 12 hours. The main power box at home is used while sleeping and for device monitoring.

The VAD Team
The VAD team at the accredited Carl H. & Edyth Lindner Heart Failure Treatment Center at The Christ Hospital consists of board certified surgeons, cardiologists, nurse practitioners, registered nurses, dieticians, exercise specialists, psychologists and social workers. All members of the team have specialized training in the care of VAD patients.

For more information, please call the Mechanical Heart Assist Device Program at 513-585-2531 or 866-556-4533.

For clinical concerns, please contact 859-572-1609.

Images provided by Thoratec Corporation

Patient brochure.
Physician brochure.

Heart Felt: Ventricular Assist Device (VAD) Support Group
The Christ Hospital welcomes you to a monthly VAD support group. If you are considering a VAD, or have current or previous VAD implantation, we encourage you and your family to join us. This support group is an open forum for education and peer support related to living with a VAD, and includes information to prepare for transplant, guest speakers and light refreshments.

Where: The Christ Hospital 7th Floor South Conference Room

When: Second Monday each month at 11 a.m. 

Please RSVP to: Gayle West, L.I.S.W. at 513-585-1755