A VAD is a pump that takes over some of the work of the heart in order to ensure that the body receives the blood it requires when the heart is not able to do it by itself. VADs can be used on the right side of the heart, the left side, or both (RVAD, LVAD, and BiVAD). They can even be used in patients who have congenital heart disease, including single ventricle heart disease. As a national leader in the use of VADs in children of all sizes, we use a variety of VADs. We use different types of VADs for patients with different requirements, including the HeartMate 3, the Berlin Heart, the CentriMag and PediMag, and the Impella. Some of these are placed inside the body, and others are connected to the body by tubes and sit next to the body.
VADs are used when heart failure is no longer well controlled with medications. VADs help preserve the function of the kidneys, lungs, and liver during late-stage heart failure. For children waiting for a donor heart, VADs help extend their lives until a donor heart becomes available.
We are pioneers in using VADs in innovative ways to treat children who have highly complex needs. For example, we accept children who have been rejected for a VAD elsewhere, including single ventricle patients. Commonly, VADs are used as a lifesaving bridge to heart transplant, keeping your child with heart failure stable and feeling better while waiting for a donor heart to become available. In some cases, VADs can be used as long-term treatment (called destination therapy) even for patients who are not actively considered for heart transplantation, although this is more common in adults than in children. A VAD is also used when a heart needs temporary support while it recovers from disease or injury (called bridge to recovery).
If you have been told that your child might benefit from a VAD, we consult with your child’s referring doctor and perform a thorough evaluation and testing to ensure that a VAD is the right next step.
Implanting a VAD requires open-heart surgery and several days or weeks in the hospital. A pediatric cardiovascular surgeon and a pediatric cardiac anesthesiologist and other heart experts perform the surgery together. The surgery typically takes four to six hours and requires that your child be placed on a heart-lung bypass machine. After surgery, your child will spend time in the cardiac ICU until he or she is stable and can be moved to a regular room for recovery. Sometimes, children are able to leave the hospital and await transplant nearby. With some types of VADs, ongoing hospital care is required until transplantation when a child cannot be medically managed at home.
After VAD placement, we educate you on how to support your child while he or she lives with a VAD, helping them regain strength and grow healthy as they await heart transplant. Often, a child who has been supported with a VAD can become stronger and has an easier time with transplantation, which is true for even very young and very small patients.