Ventricular Assist Device (VAD)

Cardiovascular specialists at the Brigham and Women’s Hospital (BWH) Ventricular Assist Device (VAD) Program, part of the Carl J. and Ruth Shapiro Cardiovascular Center, offer innovative treatments to improve the quality of life of patients with advanced heart failure.

The BWH VAD Program, one of the largest such programs in New England, is at the forefront of circulatory assist device treatment and research. In 1999, the Program performed the first left ventricular assist device (LVAD) implantation as destination (long-term) therapy in New England, and was the only New England program to participate in the landmark REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) trial. The trial was significant in its finding that patients managed with an LVAD and medical therapy fared much better than patients who were managed with medical therapy alone.

The VAD Program works closely with our Heart Transplant Program, also widely recognized for innovation and quality care. Since performing the first successful heart transplant in New England in 1984, the BWH Heart Transplant Program has performed nearly 600 heart transplants and continues to be one of busiest transplant centers in New England.  

What Are Ventricular Assist Devices?
Ventricular assist devices (VADs) are implantable mechanical pumps that support heart failure patients by improving blood flow. A left ventricular assist device (LVAD), the most commonly used VAD, supports the pumping action of the left ventricle; a right ventricular assist device (RVAD) supports the function of the right ventricle; and a biventricular assist device (BiVAD) supports the function of both the right and left ventricle.

Our VAD Services
Our cardiovascular specialists use VADs for three main purposes:

• A VAD can be used as a bridge to transplantation, temporarily supporting a patient who is waiting for a heart transplant.

• For a patient with a potentially reversible form of cardiac failure, a VAD can be implemented as a bridge to recovery. The device is implanted to help assist the heart while it recovers, and, if successful, then the VAD can be removed.

• For a patient who has irreversible heart failure but is not an ideal candidate for a heart transplant, a VAD may be used as destination therapy, helping to support circulation for many years.

Our cardiac surgeons match patients to the most appropriate ventricular assist device, which may include:

• HeartMate II, a small, durable and quiet device used as a bridge to transplantation or destination therapy.

• Abiomed’s Impella 2.5, the world’s smallest ventricular assist device, designed to be used as partial circulatory support during high-risk angioplasty or stenting.

• CardiacAssist Tandem Heart, used as a bridge to recovery or as a transition to a longer-term device.

Trial Devices:

• SynCardia Total Artificial Heart (fall of 2010), a potential bridge-to-transplantation option for patients with biventricular heart failure - features a portable external driver that enables patients to return home while awaiting a donor heart.

Our VAD Team
Led by cardiac surgeon Gregory S. Couper, MD, Surgical Director, and cardiologist Michael M. Givertz, MD, Medical Director, the VAD Program’s multidisciplinary team works together to provide the best possible outcomes for our patients with heart failure. Learn more about the members of the VAD team.

Our Ventricular Assist Device Research
Physicians and researchers in the Program are leading a range of studies of stem cell therapy, national outcome data and patient perspectives, including:

• Cardiac Stem Cell Study – a study to evaluate the role of cardiac stem cell therapy for patients with end-stage heart failure who are living with VADs.

• Registry of VAD Patients – INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) is a national registry for patients who are receiving mechanical circulatory support device therapy to treat advanced heart failure.

• Determining When Patients Consider VADs – A recently published BWH study (J Heart Lung Transplant. 2009 Sep;28(9):863-9) examines the circumstances under which patients with late-stage heart failure would consider using a VAD. 

Contact Us
To refer a patient to be considered for a VAD, heart transplant or any other advanced heart failure therapy, please contact the Advanced Heart Disease Program at (617) 732-7141.