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Ventricular Assist Devices
The Latest in Left Ventricular Assist Devices | FAQ with Dr. Ahmet Kilic
Cardiac surgeon Ahmet Kilic answers commonly asked questions about left ventricular assist devices (LVAD) and discusses improvements to LVAD technology and implantation techniques.
A ventricular assist device (VAD) is a mechanical heart-assist pump that can prolong the lives of some patients while they wait for a heart transplant. This is known as a “bridge to transplant.” A VAD can also improve the quality of life for end-stage heart failure patients who don't qualify for transplant. This is known as “destination therapy,” because the VAD itself is the therapy and not a bridge to another treatment.
- About us
- What is ventricular assist device (VAD)?
- Who could benefit from this device?
- What is heart failure?
- What should I expect?
- Surgery and Beyond
- What types of devices are available?
- Are there any ongoing studies?
- Who are the VAD teams?
- Patient testimonials
- How do I learn more?
Our program. The Johns Hopkins Hospital Ventricular Assist Device Program began in 1986 and has extended lives and improved quality of life for thousands of patients. Our program has participated in every major VAD clinical trial.
Our team. Our VAD team consists of committed and highly trained clinicians dedicated to providing our patients with the best available care. The team includes cardiologists, cardiac surgeons, cardiac anesthesiologists, cardiac perfusionists, the cardiovascular surgical intensive care unit (CVSICU) team, the cardiovascular progressive care unit (CVPCU) team, physical therapists, occupational therapists, nurses, social workers, transport personnel and VAD coordinators.
Our approach. We believe in developing a relationship with you and your family so you have a comfortable and trusting group of care givers around you at all times. We remain active in your care throughout the pre-operative evaluation phase, during the surgery, while recovering from surgery in the hospital, and after discharge while adjusting to a new life at home with your VAD.
Our approach to caring for a patient with a VAD implant is different in many areas. We fully believe in developing a relationship with you and your family so that you may have a comfortable and trusting group of care givers around you at all times. We remain active in your care throughout the pre-operative evaluation phase, during the surgery, while recovering from surgery in the hospital, and after discharge while adjusting to a new life at home with the VAD.
A ventricular assist device (VAD) is a pump that assists the failing ventricle by taking some of the workload from the heart and pumping blood to the body. Because it assists the left ventricle, the device is sometimes known as an LVAD—left ventricular assist device.
An inflow tube connects the LVAD to the heart, while an outflow tube connects the LVAD to the aorta, which delivers the blood to the rest of the body.
People with end-stage heart failure who are no longer responding to medical management may benefit from a VAD. They may be transplant candidates who would receive the device as a bridge to transplant, or those who are not candidates for heart transplant, but would benefit from destination therapy. The goal in both cases is to prolong and improve the quality of life. If you think you or someone you know might be a candidate for a VAD, contact the VAD Program at Johns Hopkins.
Heart failure means the heart can't pump as much blood as your body needs. Read more about heart failure in our Health Library.
The first stage of the process is to schedule an evaluation with our team. You will meet with a cardiologist who will discuss your current condition and will discuss all possible options to improve your health.
If your cardiologist recommends a VAD, you will meet with a cardiac surgeon to discuss the various available devices and discuss surgical aspects of the procedure. A VAD coordinator will meet with you and your family to review the VAD and all related patient care issues. If you and your doctor decide that a VAD is right for you, a series of tests will be necessary to confirm your medical eligibility for a device.
The average VAD implant surgery takes five to six hours. After surgery, you will be in the Cardiovascular Surgical Intensive Care Unit (CVSICU). The CVSICU team is a group of highly skilled professionals including physicians, nurses, nurse practitioners, respiratory therapists, pharmacists and VAD coordinators.
Once you stabilize, you will be transferred to the Cardiovascular Progressive Care Unit (CVPCU) for further treatment. You and your family will be encouraged to participate in care and learn about the ventricular assist device. This process usually begins in the CVSICU and increases as you are cared for in CVPCU.
While in the CVPCU, your nurse and physical therapist will help you start walking and, as you get stronger, help you increase your amount and variety of exercise. The main goal of physical therapy is to make you as independent as possible to allow you to return to work and an active lifestyle.
You will stay in the CVPCU until discharge. Family and close friends may visit at any time. One adult family member may stay in the room with you.
While you are in the CVPCU, the VAD team will train you and your primary caregivers about your new device. Primary caregivers may be family members or friends who agree to come to the hospital to learn about the device, how to handle emergencies, and will be available to assist with your VAD care once discharged.
After discharge, you will periodically return to the outpatient VAD clinic for routine visits.
The Johns Hopkins Hospital Ventricular Assist Device Program offers two devices for left-side ventricular failure. Your cardiologist and surgeon will determine the best device for you.
- Heartmate® II is FDA approved for both destination therapy and as a bridge to transplant.
- Heartware is currently FDA approved as a bridge to transplant and is being studied for destination therapy,.
The Johns Hopkins VAD program has been involved in all major VAD clinical trials. For information about ongoing clinical trials, please contact us.
Our Surgical Team features experts in complex heart diseases including surgical treatments for heart failure, and have performed many VAD implant surgeries. Find our complete list of surgeons below.
The OR Team includes our surgeons as well as nurses, technologists, and other physicians.
Our VAD Coordinators — Tracy Fehr, Rebecca Fioretti and Nancy Klemans — use their extensive clinical experience to help you navigate the process. Before surgery, the coordinators will meet with you to discuss the device options that the cardiac surgeon and cardiologist have selected for you. They coordinate your in-patient care from hospital admission to hospital discharge and help manage your care after you leave the hospital with your VAD.
The CVSICU and CVPCU teams involved with the VAD program will care for you in our state-of-the-art facilities after your implant surgery. These teams include critical care nurses, nurse practitioners, physicians, respiratory therapists, occupational therapists and our VAD Coordinators.
Physical therapy and occupational therapy teams involved with the VAD program are the key to your rehabilitation. Physical therapy will begin soon after your surgery and continue through most of your hospital stay.
The medical team is responsible for the clinical evaluation and management of patients referred for mechanical assist devices, and overseeing the long-term follow-up of patients who receive a device. Social workers involved with the VAD Program will help you and your family understand the system and assist with personal and social situations. They help find financial resources and housing resources, and help you and your family cope with the important, life-changing decision of choosing whether to receive a ventricular assist device.
Alex was an 18-year-old who arrived at Johns Hopkins Hospital after an acute episode of heart failure. Previously healthy, he suddenly found himself with a failing heart in need of transplant. His doctor's mission: To help Alex survive until a donor heart became available. He therefore implanted a left ventricular assist device as a "bridge to transplant." Alex went home on the device and resumed his daily routine. Alex got his heart transplant approximately 10 months after his LVAD implant. He finished high school and went on to college. "I am grateful to the team at Hopkins who really came through when I needed them," said Alex.
Mr. Millberry suffered from end-stage heart disease and had been dependent on many heart drugs to keep his ventricle from failing. At the age of 57, he needed a heart transplant. He received a ventricular assist device to help his heart function while he waited. Mr. Millberry worked very hard to rehabilitate in order to go home with the device. But the night before discharge, a heart became available for him and he was successfully transplanted. "The people at Hopkins become like family and I am tickled that we met," said Mr. Millberry.
VAD program office
VAD program email