Ventricular assist devices (VAD) pump blood from the left, right or both ventricles for patients in severe ventricular failure.
VADs may be placed temporarily (as a bridge to transplant) or permanently in patients who are not transplant candidates (also known as Destination Therapy)
Certain types of VADs continuously pump blood in a non-pulsatile fashion. In these cases, a patient may be perfusing normally without a palpable pulse.
Familiarity with potential VAD complications is important as a patient with a VAD may be presenting to an ED near you. Complications include:
Bleeding complications from anticoagulation; all VADs require some form of anticoagulation
Infection; a portion of the VAD exits externally and this site can be a portal of entry for skin flora
Embolic phenomenon from clots generated within the VAD
Infection of the VAD itself, called VAD-itis; this can also lead to sepsis
References
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