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 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 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 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 or play any water sports. No boating, hot tubs, or baths.

• Ask your provider if it's safe for you to drive.

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 medicines exactly as prescribed by your 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 healthcare provider or your VAD coordinator if it's above 100.4°F (38°C), or per your healthcare provider's instructions).

• 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 won't measure it correctly. 

Risks and complications

A VAD can help you feel better and be more active. But having one has risks. Discuss those risks with your healthcare 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 provider for all advised blood test monitoring.

• Eat a healthy diet. Ask your healthcare provider for menus and other diet information. They may advise limiting your water and salt intake.

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 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

Call 911

Call 911 if you have any of these:

• Chest pain

• Shortness of breath

• Fainting

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