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VENTRICULAR ASSIST DEVICE (VAD)

VENTRICULAR ASSIST DEVICE (VAD). DEFINITION OF VAD. A VENTRICULAR ASSIST DEVICE (VAD) IS A MECHANICAL PUMP USED FOR TEMPORARY BLOOD CIRCULATION SUPPORT. IT DECREASES THE WORKLOAD OF THE HEART WHILE MAINTAINING ADEQUATE FLOW AND BLOOD PRESSURE. Why Do We Need VADs ?.

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VENTRICULAR ASSIST DEVICE (VAD)

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  1. VENTRICULAR ASSIST DEVICE (VAD)

  2. DEFINITION OF VAD • A VENTRICULAR ASSIST DEVICE (VAD) IS A MECHANICAL PUMP USED FOR TEMPORARY BLOOD CIRCULATION SUPPORT. IT DECREASES THE WORKLOAD OF THE HEART WHILE MAINTAINING ADEQUATE FLOW AND BLOOD PRESSURE.

  3. Why Do We Need VADs? • HEART DISEASE IS THE LEADING CAUSE OF DEATH IN THE WESTERN WORLD • ~5 MILLION PEOPLE IN THE US HAVE CONGESTIVE HEART FAILURE (CHF) • 250,000 ARE IN THE MOST ADVANCED STAGE OF CHF • ~500,000 NEW CASES EACH YEAR • ~50,000 DEATHS EACH YEAR • ONLY EFFECTIVE TREATMENT FOR END STAGE CHF IS HEART TRANSPLANT

  4. INDICATIONS OF VAD.

  5. INDICATIONS OF VAD. • HAVE SUFFERED A MASSIVE HEART ATTACK • CANNOT BE WEANED FROM HEART • INFECTION IN THE HEART WALL • ARE AWAITING A HEART TRANSPLANT • ARE UNDERGOING HIGH-RISK PROCEDURES

  6. POOR CANDIDATES FOR VAD.

  7. PARTS OF ASSISTIVE DEVISE. • A pump unit • An inflow tube • An outflow tube • Internal valves

  8. POWER LEADS • THE CONTROLLER AND BATTERIES • THE TYPE OF PUMP

  9. Types of VADs • EXTERNAL • IMPLANTABLE. • PULSATILE. • NON PULSATILE

  10. INTRA AORTIC BALLON PUMP. • IABP IS A TEMPORARY CIRCULATORY ASSISTANCE TO THE COMPROMISED HEART BY REDUCING THE AFTERLOAD BY REDUCING THE SYSTOLIC BLOOD PRESSURE, RESULTING IN IMPROVED CORONARY BLOOD FLOW.

  11. INDICATIONS FOR IABP USE. • CARDIAC FAILURE AFTER A CARDIAC SURGICAL PROCEDURE • REFRACTORY ANGINA DESPITE MAXIMAL MEDICAL MANAGEMENT • PERIOPERATIVE TREATMENT OF COMPLICATIONS DUE TO MYOCARDIAL INFARCTION • FAILED PTCA • AS A BRIDGE TO CARDIAC TRANSPLANTATION

  12. CONTRA INDICATIONS FOR IABP USAGE. • SEVERE AORTIC INSUFFICIENCY • AORTIC ANEURYSM • IRREVERSIBLE BRAIN DAMAGE. • TERMINAL SYSTEMIC DISEASE. • GENERALISED PVD.

  13. IABP INSERTION.

  14. EFFECT OF COUNTER PULSATION.

  15. COMPLICATIONS WITH IABP. • LIMB ISCHEMIA • THROMBOSIS • EMBOLI • BLEEDING AND INSERTION SITE • GROIN HEMATOMAS • AORTIC PERFORATION AND/OR DISSECTION • RENAL FAILURE AND BOWEL ISCHEMIA • NEUROLOGIC COMPLICATIONS INCLUDING PARAPLEGIA • HEPARIN INDUCED THROMBOCYTOPENIA • INFECTION

  16. NURSING MANAGEMENT • DYSRHYTHMIAS. • PERIPHERAL ISCHEMIA. • BALLOON PERFORATION. • PSYCHOLOGICAL NEEDS. • IABP WEANING. • BALLOON CATHETER PLACEMENT.

  17. SUMMARY

  18. CONCLUSION.

  19. THANK YOU….

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