How to Care for a Ventricular Assist Device

It is important to follow instructions from your health care provider about caring for your ventricular assist device (VAD) at home (destination therapy). You will continue to work with a health care provider who specializes in VADs (VAD coordinator) and a heart specialist (cardiologist).

How to check the VAD

Check the area around your VAD tube every day or as often as told by your health care provider. Check for the following symptoms:

• Redness.
• Swelling.
• Blood or fluid coming from the opening.
• Warmth.
• A bad smell.

Check the following numbers and write them down every day:

• Your temperature.
• Your blood pressure.
• Your weight.
• The VAD speed (rpm).
• The VAD pulsatility index (PI).
• The VAD power.
• The VAD flow (L/min).

How to change the bandage around the VAD

You will have a bandage (dressing) around the area where the VAD tube exits your abdomen. The dressing consists of a drain sponge, gauze, and adhesive tape. Your VAD coordinator may help you order the supplies that you need to change your dressing.

To remove your VAD dressing and put on a new dressing, take the following steps:

1. Put on a mask.
2. Wash your hands with soap and water.
3. Put on germ-free (sterile) gloves.
4. Remove the dressing and throw it away. Do not touch the VAD tubing or the skin near it after you have removed the dressing.
5. Remove your gloves and put on a new pair of sterile gloves.
6. Clean the area around the VAD tube. Use a sterile cleaning solution as told by your health care provider.
7. Gently dry your skin with sterile gauze.
8. Apply the drain sponge to the VAD tubing site. Cover the drain sponge with a gauze pad.
9. Secure the dressing with adhesive tape.

Change your dressing as often as told by your health care provider.

What should I do at home if I have a VAD?

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activities

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Avoid physical activity in very hot or very cold weather.

Traveling with a VAD

• Get permission from your health care provider before you travel. You will need a letter from your health care provider that explains your medical condition and VAD equipment.
• Make sure that your VAD coordinator can reach you when you travel.
• Find VAD centers and health care facilities close to your travel destinations.
• Do not pass through metal detectors or radiation detectors. Security may need to inspect your external VAD equipment.
• Always keep the following items with you:
  • Extra equipment for your VAD.
  • Phone numbers for your emergency contacts.

General Instructions

• Make sure you understand:
  • The parts of your VAD and how they work.
  • The VAD alarm functions.
  • How to change your VAD dressing.
  • What to do in case of an emergency.
• When leaving home, take a spare system controller and extra VAD batteries with you.
• Keep all follow-up visits as told by your health care provider. This is important. You will need to have blood tests frequently.

What should I not do if I have a VAD?

• Do not expose the VAD to water. This can cause VAD pump failure.
  • Do not take baths, swim, or use a hot tub.
  • Cover your VAD equipment when you shower. Your health care provider will show you how to do this.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider. Avoid places where you may be exposed to secondhand smoke.
• Do not play contact sports or do intense physical activities.
• Do not sleep on your abdomen.
• Do not vacuum.
• Do not drive or use heavy machinery.
• Do not drink a lot of alcohol. Limit alcohol intake to no more than 1 drink per day for nonpregnant women and 2 drinks per day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.

When should I seek medical care?

See your cardiologist if:

• You have swelling in your ankles or feet.
• You gain more than 3 lb (1.36 kg) in 1 day.
• You have any of the following symptoms in the area where your VAD tube exits your abdomen.
  • Redness.
  • Pain.
  • Swelling.
  • Blood or fluid coming from the opening.
  • Warmth.
  • A bad smell.
• You have a lot of bruises.
• You feel nauseous.
• You vomit.
• You have a fever.
• You have pain in your abdomen.

See your VAD coordinator if:

• You have questions or concerns about your VAD.
• You need to order supplies for your VAD.
• You notice a VAD flow rate, PI, or power level that is abnormal.

When should I seek immediate medical care?

You should seek immediate medical care if:

• You have difficulty breathing.
• You have chest pain.
• You have pain that spreads to your arm, neck, jaw, back, or abdomen.
• You have blood in your vomit or your stool.
• You cough up blood.
• Your VAD stops working or loses power.
• Your VAD becomes damaged.
• A VAD alarm goes off.
• You have weakness or numbness of an arm, leg, or part of the face.
• You have slurred speech.