What to Expect from the Ventricular Assist Device Program
The Ventricular Assist Device (VAD) program at Cincinnati Children’s is a nationally recognized leader in supporting children with end-stage heart failure and adults with congenital heart defects. We provide comprehensive mechanical circulatory support (MCS) options to support heart function short-term, until they can get a heart transplant, or long-term.
Our team of experts offers personalized care by determining if VAD therapy is the right option and finding the best device to provide support for a sick heart. Patients come to us from across the country to receive advanced care based on the latest research.
VAD cardiologists, specialized nurses, and cardiothoracic surgeons are available 24/7 to care for new patients. You can rely on us to help your child at any time.
Most patients are referred to our team from other physicians, both within Cincinnati Children’s and from hospitals across the country. Our team also accepts patient/caregiver self-referrals for second opinions and VAD evaluations. The physician will send the necessary medical records to us before your appointment. Once we have the referral, we will call you to set up an appointment time.
If the patient is seen by an outpatient cardiologist at Cincinnati Children’s or already admitted to the hospital, the team will set up a time to discuss VAD therapy. If the patient is currently admitted to another hospital, we will discuss with the team if arranging transfer is safe and if so, facilitate transportation to Cincinnati Children’s for further evaluation.
We encourage you to bring a list of any questions you have to the evaluation. It is our goal to help you fully understand the advanced heart failure options. If you are interested in our program or are looking for a second opinion, please contact us.
End-stage heart failure patients are evaluated by a multi-disciplinary team to determine their device candidacy. There are many studies that are required to determine if a device is the best option and if it is a safe for the patient to undergo the procedure.
Each patient’s first visit with us varies depending on their health. For outpatient evaluations, the Heart Failure team will meet weeks or months before needing a VAD or heart transplant. At these appointments, we have time to get to know your family and perform testing. We stay up to date on their care and treatment goals as their condition progresses.
However, in some cases, a patient is already very sick when we meet them. In these instances, we may move quickly to evaluate if a VAD can improve the heart’s function and decide when it is the right time for VAD surgery.
No matter which circumstance you are in, we always take the time to get to know you and answer all of your questions. Our team will help you understand all advanced heart failure options, surgery timing, the suitability for heart transplantation (if eligible) and what you can expect after a VAD is placed.
During their VAD evaluation, we also will review their medical history and the causes of their heart failure. We’ll talk to you about your goals for their care. We also may perform tests such as:
- Physical exam
- Echocardiogram (heart ultrasound)
- Blood tests to check heart, lung, kidney and liver function
- Electrocardiogram (EKG)
- Chest X-ray
- Cardiac catheterization
Additionally, during the VAD evaluation, you may also meet with the following teams or specialists:
- Palliative Care
- Infectious Disease
- Psychology and Social Work
- Heart Transplant Team
Once the evaluation is completed, we will meet with a multidisciplinary care team to decide if a VAD is the best option. If approved, we will move forward with surgical timing and planning. To best prepare for a VAD, we encourage the patient to try to get the best nutrition possible to help with healing.
We’ll provide comprehensive support for your whole family beginning with the first consultation. Whether your child receives a VAD within hours or months of our meeting, we are ready to support you 24/7.
After a VAD is Placed
Here are some expectations after surgery. Patients are encouraged to talk to their care team in more detail about these topics as their surgery date approaches and throughout recovery.
- After the device is placed and the patient has recovered from surgery, the biggest risks are associated with the blood thinners that are required to keep the device functioning, which can increase risk of stroke and bleeding. Your care team will provide education on this topic and precautions to take.
- Recovery time varies depending on the size of the patient and the device that is chosen. A thorough explanation will be provided at the time of consultation since recovery time can vary from patient to patient.
- Whether the patient is able to go home with a VAD depends on the VAD that is used. Some VADs are only designed and FDA approved to be used in the hospital.
- Patients on a device that allows for discharge home will be able to lead a relatively normal life. They can exercise, travel and go to school and work. However, life with a VAD is not always easy. Everything that a patient would normally do will be different since they’ll rely on battery power and electricity. We encourage patients to discuss this with their doctor and other patients who have VADS, if possible.