University of Washington Medical Center

• Ventricular assist devices (VADs) are a proven therapy as bridge-to-cardiac transplantation in Class IIIB and
Class IV heart failure patients
• The dramatic increase in the use of VADs has been unavoidable for those patients suffering end-stage heart failure due to the consistent shortage of donor organs
• As mean support duration for VADs increases, more
VAD patients will be living in the community
• HeartMate LVAD is approved as Destination Therapy
(DT)

FDA Approved 4.21.08
• Bridge-to-Transplant (BTT)
FDA Approved 1.20.10
• Destination Therapy (DT)

Cored into LV
Outflow to aorta
Percutaneous tube
System Controller
Batteries

• Axial (continuous) flow: ?NO PULSE/ ?BP
• One moving part: Rotor
• Small
 400 gm
 125 cc
 60% smaller than HM I (XVE)
• Quiet
• Flows: 3 – 10 lpm
• Anticoagulation required

• Size: Potential BSA of .8 m 2
• Only one moving part
• Blood lubricated bearings
• Designed for long term support
• Lower infection rates (smaller perc tube)

Pump Housing
Rotor

BLOOD FLOW
Outflw
Stator
Outflow
Bearins
Rotor
Inflow
Bearings
Inflow
Stator

Controller + Back-up Controller

Supplies main power to LVAD
Provides 30 minutes of backup power
Repeats alarms generated by the System Controller
Serves as the electrical interface between the
System Controller and the Display Module

• 14v Li-Ion
• 6 – 10 hours of support *Patients report up to 15 hrs of battery power
• Up to 4 hour recharge for fully discharged battery
• 3 years or 360 charges

•Pump Mode
 Fixed
 Power Saver
•Pump Speed (rpm)
•Pulse Index
•Estimated Flow (lpm)
 Too low “---”
 Too high “+++”
•Power (watts)
•Alarm Conditions
Highest priority displayed
Fixed Speed 9600 PI 5.5
Flow 4.5 Power 8.2
Fixed Speed 9600 PI 5.5
LOW FLOW for < 1 min

• Single use battery pack in a plastic carrying case with a shoulder strap
• Provides battery power in the event of extended power outage
• Approximately 12 hours of support
• Must be replaced if used for a period exceeding three hours

BATTERY < 15 minutes of power
BEEP Q SEC
BATTERY < 5 minutes of power
STEADY TONE
Defaults to ‘Power Saver Mode’


Pump defaults to Fixed Rate Mode of 8000 rpm, or fixed speed setpoint if lower
System will return to set speed once adequate power is restored
ACTION
• Replace batteries or switch to alternate power source

SYSTEM DRIVER CELL
LOW VOLTAGE
SYSTEM CONTROLLER CELL LOW VOLTAGE
 Yellow cell symbol
 Beep every 4 seconds
ACTION
• Replace cell battery and perform
System Controller self test

POWER CABLE DISCONNECTED and FLASHING
POWER CABLE DISCONNECTED
 Flashing green power symbol & battery power bars
 Beep every second
ACTION
• Check cable connections to power source
• Check power leads for damage, replace if necessary

LOW FLOW; NO
OPERATION or
INCORRECT OPERATION
LOW FLOW < 2.5 lpm
 Pump not operating or not operating correctly
 Decreased preload (right heart failure, tamponade, hypovolemia, bleeding, etc)
 Obstruction of pump inflow or outflow
 Systemic hypertension
ACTION
• Assess patient
• Monitor

DRIVELINE DISCONNECTED
FROM CONTROLLER
• Check connections
ACTION
• Reconnect driveline to controller

STEADY TONE and
NO SYMBOL
• NO POWER TO PUMP
ACTION
• Check system driver connections to pump
• Check system driver power connections to power source
• If persist, seek additional help immediately

• STABLE
– Patient may “feel funny” “light headed” or “different”
– Pump speeds and flows are normal, low normal, or very low
– Consider cardioversion after consultation with Mechanical
Assist Device Coordinator
• UNSTABLE
– Patient unresponsive
– Treat as unstable VT/VF

• Transport to UWMC
• Spare batteries, PBU and the display module should be brought to the hospital with the patient
• PBU weighs 29 pounds without batteries
• All modes of emergency transportation are acceptable
• Aviation electronics will NOT interfere with
LVAD and visa versa

SHAUNA ANDRUS, RN
AMY UNGERLEIDER, RN
JANIE SHIVELY, RN
Mechanical Circulatory Support Coordinator
UNIVERSITY OF WASHINGTON MEDICAL CENTER
24/7 CONTACT
UW PAGING OPERATOR
206.598.6190
Ask for VAD Coordinator On Call

Assoc. Director Cardiac Transplant and
Mechanical Assist Device Programs
UNIVERSITY OF WASHINGTON MEDICAL CENTER office 206.543.3093
Paging operator 206.598.6190
MEDCON 800.326.5300