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

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

11. 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.

12. 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

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

15. IABP INSERTION.

16. EFFECT OF COUNTER PULSATION.

18. 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

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

20. SUMMARY

21. CONCLUSION.

22. THANK YOU….