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1966
When was the first successful VAD for
(It lasted 4 days)
post cardiotomy cardiac failure?
Peformed by Dr Michael Debakey
- Native function is inadequate
- Refractory to all pharmacological av-
enues (Not responding to Pressors)
- Refractory to IABP/Impella
- Short term assist
What are some indications for VAD? - Long term assist
- Post cardiotomy cardiogenic shock
- Myocarditis
- Cardiomyopathy
- End-stage congenital heart disease
- Pulmonary Hypertension
A disease of the heart muscle that affects
What is Cardiomyopathy?
its ability to pump blood effectively
What are the two types of Cardiomyopa- - Ischemic
thy? - Non-Ischemic
Why does CAD cause Ischemic con- It is blockages of arteries, so no blood
cepts? can flow to areas that need oxygenated
- Valvular Disease
- Viral Cardiomyopathy
What are some non-ischemic cardiomy- - Hypertrophic
opathies? - Hypertensive
- Peripartum
- Amyloidosis
Systolic = Heart can not pump (Eject) =
Too dilated/weak
What is the difference between systolic
vs diastolic heart failure?
Diastolic = Heart can not fill = Still cham-
bers and thick walls
Systolic only
(Because Diastolic heart failure is a filling
, Ventricular Assist Device (VAD) Actual Exam Questions With Reviewed
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issue and they do not have issues eject-
Durable VADs are for what type of heart
ing, if you don't have any volume to give
failure?
a VAD wont help)
Once you have heart failure, you always
have heart failure
Once you have heart failure, you ?
(You can not go back to a previous stage
so if you are at "C" you can not go back
to "B")
Stage A = High risk with no symptoms
Stage B = Structural heart disease no
symptoms
What are the 4 stages of heart failure? Stage C = Structural disease previous or
current symptoms
Stage D = Refractory symptoms requir-
ing special intervention
- Temporary
What are the two types of VADs?
- Durable
- IABP
What are some Temporary VADs? - Impella
- Centrifugal Pump (Centrimag)
What is the most common Durable VAD? HeartMate III
- Bridge to Recovery
What 3 primary concepts can we use
- Destination Therapy
VADs for?
- Bridge to Transplant
- Short term VAD to provide the heart
What is Bridge to Recovery? with myocardial rest for intention of re-
covery
Durable VAD, used for patients who are
not transplant candidates and need long
term LV support
What is Destination Therapy?
(This is the patients last option for heart
failure)
What is Bridge to Transplant?