Mechanical assist device
What is it?
Why is it performed?
Intra-aortic Balloon Pump (IABP), also known as Intra-aortic balloon counterpulsation (IABC) or balloon pump, is a balloon that inflates and deflates at a specified rate to help the flow of blood through the aorta and decrease the workload on the left ventricle (the main pumping chamber of the heart). Typically, this device is used to help the left side of the heart for relatively short periods of time. Because it is usually used for less than 10 days, it is referred to as “acute support.” Patients who require this type of temporary support include those with:
Implantable Ventricular Assist Device (VAD), also referred to as a ventricular assist system or VAS, is a mechanical pump that helps a weakened heart pump blood throughout the body. VADs are sometimes referred to as “artificial hearts” but in reality they do not replace the heart. Instead, a VAD supplements and helps the patient’s own heart to pump blood by taking over the function of either or both ventricles (lower chambers) of your heart when needed. A VAD is typically used when the heart is severely weakened, such as in severe or end-stage heart failure. These patients may require longer-term support. In these cases, a VAD may be used:
Total Artificial Heart (TAH) Much research has been conducted trying to develop a mechanical device that can permanently replace the heart and has no external tubes or cables. Several successful cases have been reported. However, research is continuing.
What is done?
Intra-aortic Balloon Pump (IABP)
Through the catheter, a small balloon (the IABP balloon) is positioned in the aorta. The IABP balloon is connected to a computer console that:
When the heart muscle relaxes, the balloon inflates. This increases blood flow to the coronary arteries. Just before the heart muscle contracts (pumps), the balloon deflates, creating a vacuum effect that helps blood flow from the heart. The process of inflating and deflating the balloon as the heart muscle relaxes and contracts is referred to as counterpulsation.
An IABP is usually implanted for a short period of time. When the treatment is no longer needed, the balloon and the catheter are withdrawn.
Ventricular Assist Device (VAD)
What can you expect?
Intra-aortic Balloon Pump
Ventricular Assist Device
If the VAD implantation is a scheduled procedure, you will probably be given an appointment at the hospital a week or so prior to the surgery date so several tests can be performed. Most patients are admitted the night before their surgery. You must not eat or drink anything for at least eight hours prior to surgery. Immediately before surgery, you will be given a sedative to help you relax. The chest area will be shaved and disinfected, and an intravenous (IV) line will be inserted. In the operating room, a general anesthetic is given so you will be asleep throughout the entire operation.
After you are completely anesthetized, three tubes will be inserted:
The heart must be stopped so the surgeons can work on it. To ensure your body continues to receive a flow of oxygen-rich blood, you will be hooked up to a heart-lung machine. This machine takes over the pumping action of the heart.
The surgery can take several hours. When you awaken, you will be in the recovery room or an intensive care unit (ICU). You can expect to stay in the hospital at least five days. How quickly you recover from surgery will depend in large part upon how healthy you were before the surgery. During this time, tests will be conducted to assess and monitor your condition. You and your family will also be taught what to do when you return home with your VAD. Most intermediate and long-term VADs allow people to go back to a more natural lifestyle.
Total Artificial Heart (TAH)
Last reviewed: June 2012