Information Regarding HeartWare™ LVAD

Medtronic is no longer making the HeartWare™ LVAD due to some health concerns. Please read the attached letter for specific information. Patient Information RE HeartWare LVAD

What Is a VAD?

A ventricular assist device (VAD) is a mechanical heart pump for people who have advanced (end-stage) heart failure. A VAD is surgically implanted inside your heart, but it does not replace it. The VAD assists your heart with pumping blood through your body. This can decrease your heart failure symptoms and give you more:

  • energy,
  • stamina, and
  • a better quality of life.

State-of-the-Art Technology & Individualized Care

The VAD program at U of U Health began in 1996 and has been offering patients state-of-the-art technology and individualized care ever since. The VAD team includes cardiovascular surgeons, heart failure cardiologists, VAD nurses, and support staff. Each year people travel from throughout the mountain west to receive a VAD at U of U Health. Our team implants more than 140 VADs a year.

University of Utah Health offers VAD therapy as part of its renowned Advanced Heart Failure Program. Our cardiologists, cardiothoracic surgeons, and researchers have helped pioneer cutting-edge therapies that benefit patients throughout the world.

We offer a comprehensive evaluation to help decide whether a person is a good candidate for a VAD or would benefit more from another type of heart failure therapy. The evaluation includes extensive testing, procedures, and multiple appointments with specialists.

What Can a VAD Do for You?

VADs are for people with advanced heart failure, a condition in which the heart can’t pump enough blood to meet the body’s needs. Heart failure can be a progressive disorder, meaning it worsens over time. Or it can happen suddenly.

People can manage their symptoms in the early stages with medications and lifestyle changes. They may consider a VAD when medications and other treatments are no longer effective. Another term for VAD is mechanical circulatory device.

VAD therapy carries some risks, but for many people, the potential benefits far outweigh the possible problems. If you’re awaiting transplantation or being considered for long-term VAD therapy, a VAD will help extend and improve your life.

We may give you a VAD for the following reasons:

  • Bridge-to-transplant therapy: This is an option for patients who are waiting for a heart transplant or who may qualify later for a transplant. 
  • Bridge-to-recovery therapy: This is a an option for people with reversible forms of heart failure. The VAD is implanted with the goal of removing it after the heart recovers enough of its function. 
  • Destination therapy: This is a lifetime therapy VAD option for patients who are not eligible to receive a heart transplant. 

VAD vs. Heart Transplant

A VAD is an excellent alternative to a heart transplant. It is most often used to buy time for patients with severe heart failure until a donor heart becomes available.

This is important, because donor hearts are in short supply. During that time, heart failure can cause permanent damage to other vital organs, such as the liver and kidney.

Ventricular Assist Device Types

The most common type of VAD is a left ventricular assist device (LVAD). Most people with an LVAD can return home and resume their daily routines after they have surgery and recover in the hospital.

The following are considered temporary therapies. Patients typically remain in the hospital for as long as they have these implants.

  • Right Ventricular Assist Device (RVAD) — As the name implies, an RVAD assists the pumping function of the heart’s right ventricle.
  • Biventricular Assist Device (BiVAD) — These devices help support the pumping function of both ventricles.

Our VAD team will consider each patient’s situation and recommend the VAD that will provide the most benefit for you.

What to Expect at Your Evaluation

If your cardiologist refers you to the advanced heart failure program for a comprehensive evaluation, you will undergo a series of tests and meet with various specialists. Our advanced heart failure team will carefully plan your evaluation schedule so that you have all the tests and appointments you need. They will collect your medical records, including previous test results in advance.

The evaluation includes:

  • blood tests,
  • chest X-ray,
  • echocardiogram,
  • exercise v02 test,
  • electrocardiogram,
  • heart catheterizations,
  • a pulmonary function test to measure your lung strength,
  • abdominal ultrasound and carotid ultrasound to assess blood flow through your vascular system and organs, and
  • an ankle-brachial index (ABI) test to check how well your blood is flowing through your arms and legs.

You also will meet with members of the care team to discuss non-medical topics. These team members include a:

  • financial counselor,
  • social worker,
  • palliative care specialist, and
  • psychologist (if needed).

The evalutation process may take several day. It can be done in our clinic or during your stay if you are hospitalized. 

If you do not live near Salt Lake City, you may want to consider staying nearby while you participate in the evaluation. We offer patient and family housing at reasonable rates, and our team can recommend other options as needed.

When all of your test results are available, the VAD team will meet to review your results and talk about which treatment option is best for you. We will recommend one of the following:

  • putting you on the waiting list for a heart transplant;
  • implanting a VAD as a bridge to transplant, bridget to recovery, or destination therapy;
  • continuing to manage your heart failure with medication and other non-surgical therapies; or
  • considering you for a heart failure research study.

If we recommend VAD therapy, the next step is to help you prepare for surgery.

VAD Surgery

We will implant the VAD using open-heart surgery. The procedure generally takes four to six hours. You will receive general anesthesia (be put to sleep) before the surgery begins. After surgery, you will stay in the cardiovascular intensive care unit (CVICU) for about a week, then spend another couple weeks in a step-down unit.

During your hospital stay, our care team will work to:

  • manage post-operative pain,
  • adjust your heart medications,
  • provide extensive education to you and your family, and
  • begin physical and occupational therapy.

During your hospital stay, you and your family members will become experts in caring for your VAD and managing your care. Our goal is to help you experience the best outcome possible and enjoy a good quality of life with your VAD.

After your hospital stay, you may go to a rehabilitation facility or to the home setting, depending on your needs.

VAD Complications

As with any major surgery, implanting a VAD can lead to complications. 

The VAD team will talk to you about these risks and monitor your health and VAD function to make sure everything is going well after surgery. 

Living With a VAD

Returning to your daily activites can take some time after VAD surgery. However, a VAD should give you more energy since it increases the blood flow throughout your body. Your heart failure symptoms, such as fatigue, shortness of breath, and swelling should decrease over time. Your kidney function may improve as well.

Most people with a VAD can go on errands, socialize outside the home, return to work, participate in sporting events, garden, and even travel.

The VAD team will talk to you about the importance of physical exercise and help you set goals. Most VAD patients can participate in most activites. We encourage patients with a VAD to avoid high-contact, high-impact sports to avoid injury.

Lifestyle Changes With a VAD

Also, VADs are not waterproof and should not get wet. You will need to protect the VAD with a specially designed shower kit when you take a shower. You will not be able to swim, hot tub, or take a bath as long as you have a VAD.

In addition, you will not be able to undergo magnetic resonance imaging (MRI) since MRI machines use large magnets that could injure you or damage the VAD.

Follow-Up Care

The VAD team will continue to monitor you closely after your surgery. If you do not live close to Salt Lake City, we will help you transition back to the care of your local primary care provider and cardiologist. Our team will provide VAD-specific education to your community.

As long as you are living with the VAD, we will continue to follow your care and be available 24/7 for any concerns and questions you have.

Making an Appointment

Physician referrals are welcome but not always necessary. To make an appointment for a heart failure evaluation at U of U Health, call 801-585-5122 or request an appointment online.

Before scheduling your appointment, our team also will request medical records from your cardiologist to help plan your visit.