Dr. Dan Raess, M.D., F.A.C.C., F.A.C.S., Medical Director

During Dr. Raess's 20-year tenure at Cardiac and Vascular Surgery Associates (CVSA) in Indianapolis, IN, and more than 15 years using Ventricular Assist Devices (VADs), Dr. Raess worked extensively with Abiomed technology, having supported more than 50 patients on Abiomed's BVS® 5000 Biventricular Support System and the AB5000™ Circulatory Support System. He has shown very high recovery rates (87%) utilizing the AB5000 technology, having recovered the native heart function for seven out of eight patients with such illnesses as viral myocarditis and acute myocardial infarction (AMI or heart attack).

Frequently Asked Questions

Click on question to view answer

---

• Are ventricular assist devices suitable for everyone?
  Ventricular assist devices(VAD) can be used for several reasons such as heart failure following a heart attack or immediately after heart surgery. All of these situations have one thing in common; the heart can not do it’s job well enough to supply all of the other organs, such as the liver and kidneys and therefore keep the patients alive. The VAD takes over pumping activity of the heart allowing it to rest until such time as the heart muscle can resume its usual job. If it becomes likely that the muscle cannot recover after being supported for an adequate amount of time, the VAD can support the patient until a donor heart becomes available.
  
  

  [ close ]
• Why do they need to have a VAD, does it mean the surgery went wrong?
  Try to imagine having a knee operated on and walking out of the OR. Or, having a stomach operation and immediately after eat a seven course meal. Yet that is what we ask the heart to do every day immediately after operations. Sometimes, despite all the measures that surgeons have at their disposal to get the heart (and the patient) though these events, sometimes the hearts are so debilitated that they simply will not provide enough flow to take care of the other organs and organ systems. This can occur immediately and usually happens within the first 24 hours. Certainly, if a VAD is used, it is an indication of forward thinking and certainly does not mean that the surgery was inadequate.
  
  

  [ close ]
• Do only select hospitals have heart recovery technology?
  Over 800 US hospitals have BVS with about 50 centers using the AB. Many cardiac surgeons do not want to go to hospitals that don’t have this lifesaving technology and consider having either a BVS or an AB to be on the mandatory equipment for an open heart center.
  
  

  [ close ]
• Once put on a ventricular assist device what will my family member look like?
  Many patients will look about the same as anyone else who would come out of a general anesthesia after a major operation. Some of those patients are very pale and swollen. They will have tubes in every orifice and tubes in the chest to drain a little extra blood and air. Usually when you first see them, they are asleep and the ventilator is breathing for them with the endotracheal tube thru the mouth and into the airway. In addition to all of that, the patients will have either two more tubes to carry blood out of the heart and the into the aorta. If the patient requires biventricular support there are four additional tubes exiting the chest from just under the rib cage. One additional thing is that the tubes connecting the pump will carry the blood outside the body and that can be disturbing to some people.. Sometimes, if the heart is swollen, the surgeon may elect the leave the chest open for several days so that the edema can decrease. If the patient has an open chest he/she will be kept sedated and sometimes even medically paralyzed to prevent the patient from moving.
  
  

  [ close ]
• Will they be in any pain?
  When talking with patients about heart surgery over the past 22 years of clinical practice, the majority of the patients say that they were stiff and sore, but very few had what they would consider severe pain. Several patients have told me that on the first postop day it felt like they did a bunch of push-up and got very sore, but that was the worst of it. The medication that patients receive in the OR actually causes amnesia during and after the surgery. When they are in the ICU after surgery, the nurses are very skilled at determining the amount of discomfort that the patients are feeling, and they will give the patient pain medication directly into an IV site. Many families are very worried if the chest stays open for a few days, the patient will be in horrible pain. That is actually not the case. Since the bone does not come together, there is actually less pain than if the chest was closed. These patients are generally sedated to prevent excessive movement until the chest is closed. Most patients are on oral pain medication after the first day.
  
  

  [ close ]
• Will they be able to talk?
  When patients have the breathing tube in place, they will be unable to talk. Once it has been determined that the patient is strong enough to get the tube out, it will be removed by the nurse or respiratory therapist. After that, they will instruct the patient to try not to talk in anything above a whisper. Most patients who have a VAD will be able to have the breathing tube removed, but it may take longer, perhaps as long as a week.
  
  

  [ close ]
• Will I be allowed to spend time with them in their room?
  Family members are usually allowed into the room as much as possible, but each hospital and each unit have their own rules. If the patient is required to have the breathing tube in place for a prolonged period of time, contact with family members is important. I feel that the family should talk to the patient even if he appears to be totally sedated. I think it helps. I try to make sure that the families concentrate on the positive and be encouraging, even if you don’t feel like it.
  
  

  [ close ]
• How long will they be in the hospital?
  Every case is different, but generally the patients are in the hospital for a week to 10 days after the VAD has been re moved.
  
  

  [ close ]
• What is their chance of survival?
  When a patient goes on circulatory support, they are by definition the sickest of the sick. The actual survival rates vary according to the situation, patient age, and comorbidities, such as hypertention and diabetes. Because there is so much variability in how patients progress through this type of situation, your surgeon will be able to give you an idea of what the chances for survival are. No matter how grim it may seem at the start or a VAD run, it is important to be positive with the patient and to take good care of other family members. Try to get enough sleep and try to eat regularly, even if you don’t feel like it. Remember that each hour that goes by increases the likelihood of survival. Without VAD therapy, there truly would have been no hope for many people.
  
  

  [ close ]

If you have additional questions that were not addressed above please contact
heartrecovery@abiomed.com