A right ventricular assist device (RVAD) is a mechanical pump that temporarily takes over or supplements the pumping function of the right ventricle. It draws blood from the right side of the heart (typically the right atrium) and pumps it forward into the pulmonary artery towards the lungs, bypassing a failing right ventricle. Unlike a left ventricular assist device (LVAD), which supports the systemic circulation, the RVAD supports the pulmonary circulation.
RVADs may be implanted surgically or positioned percutaneously (via a catheter, without open surgery). They are used when the right ventricle is acutely or chronically unable to maintain adequate forward flow. Indications include right heart failure following LVAD implantation (where the increased venous return overwhelms the right ventricle), right heart failure after cardiac surgery, acute massive pulmonary embolism, and right ventricular myocardial infarction.
In cardiac arrest with right heart failure refractory to other treatments, mechanical circulatory support including an RVAD may be deployed as a bridge to recovery or transplantation. The device can be combined with an LVAD (biventricular assist) when both ventricles are failing. Temporary RVADs aim to give the right ventricle time to recover its function.
Management of patients on an RVAD requires specialist care in a centre experienced in mechanical circulatory support. Risks include bleeding, infection, arrhythmia, and device malfunction. For the broader category of assist devices, see Heart Assist Device.
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