Discharge Instructions for a Ventricular Assist Device (VAD)
You had a procedure to insert a ventricular assist device (VAD). This device replaces the pumping action of your heart. Usually, a VAD is inserted as a bridge to a later heart transplant. But healthcare providers have also found that a VAD gives the heart a chance to rest and recover. In some cases, the heart is able to resume some normal activity, which may eliminate the need for a heart transplant. For some people who are not candidates for a heart transplant, the VAD is considered permanent. This is referred to as destination therapy.
There are different styles and brands of VADs. Caring for your VAD will depend on the type you get. Some VADs work with a pump that uses air (pneumatic). Most newer devices are not pneumatic operated. They have a power source and a small pump.
Here's what you need to know about home care.
Don't lift, pull, or push anything heavier than 10 pounds during the first 6 weeks after your surgery.
Shower with care. Your VAD has an air vent and a filter. Keep fluid away from these at all times.
Don't swim or play any water sports. No boating, hot tubs, or baths.
Your VAD is a very special device. It needs a special team to help you with care. Always know who this team is and how to reach the coordinator.
Keep the following near you at all times:
Hospital's paging number for the VAD coordinator heart transplant coordinator
Backup power pack with charged batteries
Test your system every day.
Make sure your family or someone in your home knows how to change the power supply and care for your device.
Notify the power company that you have a VAD. The power company will place you on a priority list to have your power restored first in case of a power outage. Your VAD coordinator can assist you with this. It should be done prior to your discharge from the hospital.
Carry an ID card that identifies your device.
Take your temperature every day. Call your healthcare provider or your VAD coordinator if it is above 100.4°F (38°C).
Make sure you understand how to monitor your blood pressure with the VAD. Monitoring your blood pressure will be different. A normal blood pressure cuff will not measure it properly.
Other home care
Change the device filter according to the directions you were given before you left the hospital. If you did not receive directions, ask for them.
Take your medicines exactly as directed. Don't skip doses.
Monitor your blood carefully to prevent it from being too thick or too thin, which can cause bleeding. You will have to be on blood thinners to prevent blood clots from forming in the device. Blood clots can cause a stroke or other arterial blockage.
Eat a healthy diet. Ask your healthcare provider for menus and other diet information. Generally, you should avoid drinking more than 2 liters of water in a day or eating more than 2,000 mg of salt.
When to call your healthcare provider
Call your healthcare provider right away if you have any of the following:
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Signs of infection at your device's exit site (redness, swelling, drainage, or warmth)
Device alarm sounds
Black soot in the air filter of the device
Fatigue that doesn't get better
Dizziness that doesn't go away
Shortness of breath
Swollen hands, feet, or ankles
July 15, 2017
Givertz, MM. Ventricular Assist Devices: Important Information for Patients and Families. Circulation (2011); 124(12); pp. e305-e311., Practical management of long-term mechanical circulatory support devices. UpToDate., The 2013 International Society for Heart and Lung Transplantation Guidelines for Mechanical Circulatory Support: Executive Summary. Feldman, D. The Journal of Heart and Lung Transplantation. 2013, is. 32, ed. 2, pp. 157-87.
Cunningham, Louise, RN,Fetterman, Anne, RN, BSN,Mancini, Mary, MD