Understanding Percutaneous Ventricular Assist Device (PVAD)

Introduction

A percutaneous ventricular assist device (PVAD) is a small pump designed to aid the heart’s pumping function following an injury or during specific heart conditions. This guide offers an overview of PVAD, including its purpose, procedure, risks, and post-treatment expectations.

Purpose of PVAD

A PVAD is used as an emergency measure to support recovery from heart failure or during complex coronary artery disease treatment. The device assists the heart’s pumping mechanism and is typically inserted into the left ventricle.

Procedure Overview

The procedure involves the following steps:

1. Preparation: Your healthcare team evaluates your condition to determine if a PVAD is suitable. Certain conditions or factors might affect eligibility.
2. Insertion: An intravenous (IV) line is placed in a vein. You may be given a sedative to help you relax, and anesthesia to numb the insertion site. A catheter is inserted into the appropriate artery – often the femoral artery in the groin area or the subclavian/axillary artery near the collarbone.
3. Catheter Advancement: The catheter is carefully threaded through the artery towards the heart. Imaging tests ensure accurate catheter positioning.
4. Positioning and Connection: The catheter is guided through the aortic valve and into the left ventricle. Its free end is connected to a computerized console that powers and controls the pump.
5. Monitoring: While the pump is active, your heart’s performance and blood pressure are monitored. The insertion site is covered with a dressing.
6. Treatment Continuation: You remain in bed at the hospital under continuous monitoring. Blood pressure, heart rate, breathing rate, and blood oxygen levels are closely observed.

Removal and Recovery

The PVAD is used until your heart sufficiently recovers to pump blood independently. When discontinuing treatment:

• The pump is gradually turned down.
• The catheter is removed via a procedure. The insertion site is closed with stitches or surgical tape.

Risks and Considerations

While generally safe, PVAD procedure entails some risks:

• Bleeding due to blood-thinning medication, possibly requiring transfusions.
• Blood clot formation leading to stroke or pulmonary emboli.
• Poor leg blood flow causing damage.
• Aortic valve damage.
• Abnormal heart rhythms.
• Infection or allergic reactions.
• Possible damage to other structures or organs.

Conclusion

A percutaneous ventricular assist device (PVAD) is a temporary heart support pump used during heart failure recovery or complex coronary artery disease treatment. By understanding the procedure, risks, and post-treatment care, patients and their families can be better prepared for this emergency intervention. It’s crucial to follow healthcare providers’ guidance and maintain open communication with them throughout the process. Always consult your healthcare provider for personalized guidance.