What is ventricular assist?
Ventricular assist is a device implanted in the heart that helps the heart muscle pump blood from the chambers in the lower part of the heart (the ventricles) to the rest of the body through veins, arteries and blood vessels.
This device, which functions as a kind of mechanical pump, is used in people who suffer from heart failure or who have a weak heart for some reason.
As such, the procedure of implanting a ventricular assist device requires open-heart surgery to be performed under general anesthesia, so its implantation presents significant risks. The procedure lasts between four and six hours.
There are three types, the left ventricular assist device, the right ventricular assist device and the biventricular assist device, which supports both chambers.
Why is ventricular assist performed?
The ventricular assist device is used in different cases:
- The patient needs a heart transplant. The ventricular assist device will be used temporarily until the donor heart arrives, being known as the bridge to transplantation. The ventricular assist device keeps the blood pumping and flowing even though the heart is not performing as it should.
- The patient does not qualify for transplantation because he or she has other diseases. In these cases, the implant is performed if the patient has failure but cannot undergo transplantation because of other diseases. In some cases, the ventricular device may improve the function of other organs or even the diseases that made transplantation unfeasible.
- The patient is not a good candidate for transplantation. Assistive devices are increasingly used as a long-term treatment to combat failure but who for one or more reasons is not a candidate for transplantation, such as a person over the age of 65.
- The patient’s heart function may return to normal. There are cases where a patient has temporary heart failure. In these cases, the device can be implanted as an assistant until the myocardium regains its normal activity and pumps blood on its own. The assist device may be implanted temporarily after some cardiac surgeries.
Ventricular assist may be used as a temporary device.
while the heart recovers its usual strength and health.
What does ventricular assist consist of?
The procedure to install a ventricular assist device is an open-heart procedure and may involve significant risks to the patient’s health.
During the surgery, the patient will be connected to a ventilator, which will be connected to the patient through a tube that will reach the lungs.
Once the incision has been made and the rib cage has been opened, the medical team will implant a ventricular assist device. Previously, medications may have been used to stop the heart. In this case, the patient will be connected to a cardiopulmonary bypass machine to keep the blood oxygenated.
The surgical team will then implant the ventricular assist device. It will work with a tube that will transport blood from the left ventricle of the heart to a pump, which will transport the blood into the aorta.Once the device is working properly, the patient will be disconnected from the bypass machine.
Preparing for the ventricular assist operation
When assessing the disease, medical tests such as echocardiogram, chest x-ray, electrocardiogram and cardiac catheterization may be ordered.
The medical team will have to teach both the patient and his family how to use the device and, above all, how to learn to live with it.
Care after ventricular assist surgery
After undergoing the procedure, the patient will spend a few days in the ICU, and intravenous medications, fluids and food will be administered. The lungs may not work properly, so the patient may need to be on a ventilator for a few days.
Activity is gradually restored, and the team of professionals will work with the patient until he or she can go home.
For a period of time, the patient will need to take antibiotics and anticoagulants to avoid infections and other complications.
The patient will have to attend follow-up consultations and undergo various tests to monitor his or her state of health. During the first month, a weekly follow-up visit will be necessary to check if the device is working properly.
Alternatives to ventricular assist
As discussed above, the implantation of a ventricular assist system or device can be an alternative treatment to heart transplantation, which mainly consists of using a donor heart to replace a patient’s diseased heart.
The ventricular assist device can be used as a bridge in the waiting time for the patient to receive the donor heart and undergo transplantation or in cases where the patient is ineligible to undergo myocardial transplantation because of other diseases or simply because he or she does not meet the basic criteria, such as being over 65 years of age.