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What Are the Risks of a Ventricular Assist Device?

Getting a ventricular assist device (VAD) involves some serious risks. These risks include:

  • Blood clots
  • Bleeding
  • Infection
  • Device malfunctions
  • Right heart failure (a possible risk of LVADs)

Thanks to newer VAD models, some of the most serious risks have decreased.

As with any surgery involving the heart, complications can sometimes be fatal. However, survival rates for VAD surgery have improved over the years.

Blood Clots

When your blood comes in contact with something that isn't a natural part of your body, such as a VAD, it tends to clot more than normal. Blood clots can disrupt blood flow and block blood vessels leading to important organs in the body, such as the brain.

Blood clots can lead to serious complications (such as stroke) or even death. Thus, you'll likely need to take anticlotting medicines for as long as you have a VAD.

Bleeding

The surgery to implant a VAD is complex, and bleeding may occur during and after surgery. Anticlotting medicines also raise the risk of bleeding.

Balancing the anticlotting medicines with the risk of bleeding can be hard. Make sure to take your medicines exactly as your doctor prescribes.

Infection

With implantable VADs, a pump inside your body is attached to a power source outside of your body. With transcutaneous VADs, a pump outside of your body is attached to your heart.

For both types of VADs, the parts inside your body are attached to the parts outside of your body through a hole or holes in the skin. Holes in the skin increase the risk of bacteria getting in and causing an infection.

With permanent tubes going through your skin, the risk of infection is serious. Your medical team will need to closely watch you if you have any signs of infection, such as soreness over the site of the VAD, fluid drainage, or fever.

Device Malfunctions

VADs can malfunction (not work properly) in different ways. A VAD's:

  • Pumping action may not be exactly right
  • Power may fail
  • Parts may stop working properly

Newer continuous flow VADs might reduce the risk of device malfunctions.

Right Heart Failure

Right heart failure means that the heart's right ventricle is too weak to pump enough blood to the lungs. This condition can happen as a result of getting an LVAD, which only supports the left ventricle.

The LVAD pumps a lot more blood than your weak left ventricle did. This puts more pressure on the right ventricle to pump the same amount of blood. The right ventricle might be too weak to match the LVAD's pumping ability.

Thus, you may need extra support for your right ventricle. Usually, you only need this support until your right ventricle recovers or until you get a heart transplant (if you're a candidate).

Medicines might improve the function of the right side of your heart. However, some people need a right ventricle assist device (RVAD) for short-term support of the right ventricle.

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March 31, 2012