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 and may be used for your left ventricle (most common), right ventricle, or both ventricles. Usually, a VAD is inserted as a bridge to a later heart transplant. But health care 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. This may eliminate the need for a heart transplant. For some people who aren't 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. They have a control unit (small computer) and a power source that can be plugged into a power supply (wall outlet), or that use rechargeable batteries.

Here's what you need to know about home care.

Activity

• Don't lift, pull, or push anything heavier than 10 pounds during the first 6 weeks after your surgery.

• Don't let your control unit or power source get wet. Discuss care of the control unit and power pack with your care team before discharge. Getting your power source wet could stop your VAD. Discuss washing with your care team.

• Don't swim, play water sports, or play contact sports. Don't go boating, use hot tubs, or take baths.

• Ask your health care provider if or when it's safe for you to drive.

• Talk with your provider about what types of exercise and activities are safe for you.

Special precautions

• 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 or heart transplant coordinator

  • Spare controller and backup power pack with charged batteries

• Take all your medicines exactly as prescribed by your health care provider.

• 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. They will place you on a priority list to have your power restored first in case of a power outage. Your VAD coordinator can help you with this. It should be done before you leave the hospital.

• Carry an ID card that identifies your device.

• Take your temperature every day. Call your health care provider or your VAD coordinator if it's above 100.4°F (38°C), or per your provider's instructions).

• Make sure you understand how to keep track of your blood pressure with the VAD. Keeping track of your blood pressure will be different. A normal blood pressure cuff won't measure it correctly. 

• You may need to adjust the way you sleep so that you aren't lying on your VAD.

• You will need to take good care of the exit site. Watch it daily for signs of infection, such as redness, soreness, discharge, or warmth.

• Follow the instructions on how to do the dressing changes needed to maintain your driveline (cable) and to keep it clean and covered.

• While traveling, make sure that you take enough charged batteries with you to sustain the pump function until you get to your destination.

Risks and complications

A VAD can help you feel better and be more active. But having one has risks. Discuss those risks with your health care provider. Here are some of the most common or serious complications:

• Device doesn't work

• Infection

• Bleeding

• Blood clots

• Stroke

• Aortic valve leaking (regurgitation)

• Abnormal heart rhythm

Other home care

• Take your medicines exactly as directed. Don't skip doses.

• 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. Follow up with your health care provider for all advised blood test monitoring.

• Eat a healthy diet. Ask your provider for menus and other diet information. They may advise limiting your water and salt intake. Also ask what types of food can interfere with your blood thinners.

• Talk with your provider before taking over-the-counter medicines, vitamins, herbs, and supplements.

When to contact your doctor

Contact your health care provider or get medical care right away if you have any of the following:

• Fever of 100.4°F (38°C) or higher, or as advised by your provider

• Signs of infection at your device's exit site (redness, swelling, drainage, or warmth)

• Device alarm sounds

• Extreme tiredness (fatigue) that doesn't get better

• Dizziness that doesn't go away

• Swollen hands, feet, or ankles

• Dark-colored urine, or dark or tarry stools (bleeding)

Call 911

Call 911 if you have:

• Chest pain.

• Shortness of breath.

• Fainting.

• Numbness or weakness on 1 side of your face or body.