Mechanical Circulatory Support Device

cardiothoracic referral form buttonA ventricular assist device (VAD) is a mechanical device that helps a weakened heart by taking on some of its workload. It works by taking over the pumping action of a failing heart ventricle to provide adequate blood circulation throughout the body. Since 2002, Tampa General Hospital’s Mechanical Circulatory Support Program has been committed to the care of individuals with end-stage heart disease. TGH’s Ventricular Assist Device Program has received advanced disease-specific certification from The Joint Commission. VADs can be used for three specific purposes:

  1. As a bridge to recovery: A VAD can be used to support a patient after a difficult bypass surgery but is removed in a few days when the patient's heart recovers.

  2. As a bridge to transplant: A VAD can be used to support a patient until a donor heart becomes available.

  3. As destination therapy: Some VADs can be implanted permanently for long-term therapy in patients with severe heart failure who are not candidates for heart transplantation.

Tampa General’s Mechanical Circulatory Support Program offers a variety of devices. From 1996 to early 2002, AbioMed and Novacor were the sole devices used to support patients waiting for transplantation. In April 2002, we added the Thoratec and HeartMate systems, which provide long-term support. As of December 30, 2008, over 150 patients have received VAD support at Tampa General either as a bridge to recovery or transplant, or as a destination therapy, making us one of the busiest centers in the nation to provide VAD therapy. Click here for the Cardiothoracic Transplant Referral Form.

Types of VADs

The specific device that is best for you will be determined by your surgeon based on your situation and body type. Commonly used VADs for left ventricular support are the Thoratec HeartMate XVE and HeartMate II. The Thoratec Paracorporeal VAD and Intracorporeal VAD are used for biventricular support.

Thoratec PVAD
Thoratec PVAD

Thoratec® IVAD and PVAD The Thoratec VAD (Ventricular Assist Device) is a very versatile system, offering the clinician several different applications based on individual patient needs. The system is comprised of an external (paracorporeal) blood pump and tubes. These are specialized tubes that are surgically implanted in the patient’s heart and blood vessels. The system shunts blood from the weakened heart and pumps it directly into the circulatory system. The VAD is then attached to a portable power source and driver, which alternately applies positive and negative pressure to assure adequate filling and emptying of the blood pumps (VAD).

  • The system can be used for the right side, left side or both sides for biventricular circulatory support.
  • Fits a wide range of patient sizes
  • FDA-approved for bridge to transplant or post-cardiotomy recovery
  • Power source is AC, DC car adapter or battery; can hand-pump for power during emergency situations
  • Pulsatile flow; will be able to palpate pulse and can assess BP with an automatic BP cuff
  • Must be attached to a power source at all times (AC, car adapter or batteries)

Thoratec HeartMate II LVAD
Thoratec
HeartMate II
LVAD

Thoratec HeartMate II
Thoratec
HeartMate II

HeartMate II® Left Ventricular Assist Device The HeartMate II LVAD (left ventricular assist device) is a continuous flow, implantable pump. The LVAD or blood pump is surgically implanted with one end directly placed in the left side of the heart and the other end connected to the aorta (large blood vessel that is attached to the heart). The pump serves to divert some of the blood flow from the weakened heart directly into the circulatory system. It is then attached to a driveline, which is tunneled through the abdomen and exits through the abdominal wall. This driveline attaches to a controller (microprocessor) and is powered by either AC adaption or batteries.

  • Quiet operation; auscultate over chest wall to hear a low-pitched whirling sound

  • May not have a palpable pulse; important to assess for adequate blood flow (i.e., mental status, skin color and temperature)

  • Routine assessment of BP is challenging and, at times, unreliable

  • Best to use Doppler/BP cuff; first sound when cuff deflated is considered to be mean arterial blood pressure (MAP); goal for MAP is 60-90 mmHg

  • FDA-approved for bridge to transplant or destination therapy (permanent therapy)

  • Updated controller now available with display of pump parameters and alarm troubleshooting

  • Must be attached to a power source at all times (AC, car adapter or batteries)

HeartWare LVAD
HeartWare LVAD

HeartWare® Left Ventricular Assist Device The HeartWare LVAD (left ventricular assist device) is a surgically implanted, continuous centrifugal flow VAD.  The VAD is directly sewn in to the left side of the heart and the other end of the tube is sewn in to the circulatory system.  The driveline is tunneled through the abdomen, exiting the body through the abdominal wall. The driveline is attached to a controller, which displays the pump parameters such as flow and any active alarms status.The controller is then attached to a power source: AC adapter, car adapter or batteries.

  • Quiet operation; auscultate over chest wall to hear a low-pitched whirling sound
  • May not have a palpable pulse; important to assess for adequate blood flow (i.e., mental status, skin color and temperature)
  • Routine assessment of BP is challenging and, at times, unreliable
  • Best to use Doppler/BP cuff; first sound when cuff deflated is considered to be mean arterial blood pressure (MAP); goal for MAP is 60-90 mmHg
  • FDA-approved for bridge to transplant
  • Must be attached to a power source at all times (AC, car adapter or batteries)

Tampa General Hospital is a member of the Heart Hope Consortium of Ventricular Assist Device Centers. This consortium is committed to providing their patients with the continuum of advancements in the treatment of heart failure.

For more information about TGH's Ventricular Assist Device Program, please call (813) 844-8997.  Office hours are Monday - Friday, 7:30 a.m. - 4:00 p.m.

For VAD patients

What to Keep Packed in your VAD Travel Bag at All Times

  • Extra batteries(quantity based on length of excursion)
  • Extra controller (backup controller)
  • Lovenox® syringe (note expiration date)
  • Extra battery clips
  • Medication/medication list
  • Emergency contact info
  • Luggage tag
  • MedicaAlert® bracelet
  • Poncho

In case of emergency:

  • Call 911
  • Contact the VAD coordinator pager at 1-866-844-8237 (TGH-VADS).  If you do not hear back from the coordinator after page twice, call the hospital operator at (813) 844-7000 and ask for the VAD coordinator.

Non-emergency:
Phone: (813) 844-8997
Fax: (813) 844-7000
E-mail:VADteam@tgh.org
Office: Harbourside Medical Tower
5 Tampa General Circle, Suite 527
Tampa, FL 33606