Help on vads?

VADs are designed to assist either the right or left ventricle, or both at once. The choice of device depends on the underlying heart disease and the pulmonary arterial resistance which determines the load on the right ventricle. Generally when pulmonary arterial resistance is high, right ventricular assist becomes necessary. Because the devices generally result in blood flowing over a non biologic surface, predisposing the blood to clotting, there is need for anticoagulation. There is one device, the Heartmate, which provides a biologic surface derived from fibrin and does not require long term anticoagulation; unfortunately, this biologic surface may predispose to infection.