Heart Transplant
VAD Implantation: What to Expect

VAD Implantation: What to Expect

Potential VAD patients are designated as either bridge-to-transplant or destination therapy. Bridge-to-transplant patients have already been accepted for transplant and require a VAD to support them until a transplant is available. If you are not eligible for transplant, your VAD is considered destination therapy, meaning you will have lifelong VAD support. Keep in mind that your therapy designation may change depending on your health status.

Before Your Surgery

As a potential VAD patient you will undergo a series of tests to determine suitability prior to implant. This process includes:

The specific tests you are given will be determined by your cardiologist.

In addition to diagnostic and screening procedures, you will meet the Stanford Hospital VAD Coordinator and receive pre-implant VAD education. You will have the opportunity to ask questions, watch educational videos, read additional materials and meet other VAD patients.

VAD Surgery

A variety of factors will affect the length of the VAD implant surgery. On average the surgery takes four to eight hours. Most surgeries are scheduled in advance; however some may be performed emergently. During the implant procedure, your family and friends will wait in the ICU waiting area and may receive periodic updates regarding the progress of the surgery.

The operative procedure requires a midline incision to the sternum to access the diseased heart. You are placed on a heart and lung bypass machine while the VAD is implanted into the diseased heart. Upon implantation of the VAD, you will be removed from the heart and lung bypass machine, monitored closely and taken to the Intensive Care Unit (ICU).


Upon arrival to the ICU you will remain sedated and connected to a breathing machine called a ventilator. You will also be connected to many tubes and drains including a catheter in the bladder to drain urine and tubes to drain any fluid from the chest. You also will receive intravenous medications through a catheter in the neck. You will continue to be monitored very closely while you awaken from surgery. Once you are awake and able to breathe on your own, the breathing tube will be removed.

Depending on the pace of recovery, patients typically remain in the ICU for four to five days while intravenous medications are weaned. During the ICU stay multiple tests are performed including laboratory testing, echocardiograms and chest X-Rays. Physical and occupational therapists as well as a dietician will begin working closely with you throughout your recovery.

You will be transferred to the Intermediate ICU to continue recovery. On average patients remain in the hospital for 14 - 21 days after VAD implantation. During this time you and your caregivers will begin learning about your new device. Members of your VAD team will help you understand:

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