Why is this procedure done?
Heart failure happens when the heart has trouble pumping the right amount of blood through the body. When the pump is not working well, blood can back up into the lungs. It may cause swelling in the legs or other parts of the body. ‚
Heart failure is a long-term problem which may get worse over time. Doctors work hard to treat heart failure in order to keep it from getting worse. Sometimes, doctors will use a device to help the heart pump blood. This is called a ventricular assist device or VAD. If it is helping the right side of the heart pump blood to the lungs, it is a right VAD or RVAD. If it is helping the left side of the heart pump blood out to the body, it is a left VAD or LVAD. If devices are used on both sides of the heart, it is called a biventricular assist device or BiVAD. People with severe heart failure or those waiting for a heart transplant may need a VAD. Doctors most often suggest a VAD when a pacemaker and drugs can no longer manage heart failure. Not everyone with heart failure is able to get a VAD. ‚
The VAD has three major parts: a mechanical pump, a controller, and a power supply. With a VAD, blood leaves the ventricle. Then, it flows through the VAD tube. The pump pushes the blood to the blood vessel and out to the body or lungs. ‚
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What will the results be?
- The heart will work better than it did.
- You will feel better and be able to do some activities you could not do.
What happens before the procedure?
Most of the patients who undergo this procedure are already staying in the hospital for treatment on their condition. ‚
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- Chest x-ray
- Echocardiogram
- Electrocardiogram (ECG)
- Cardiac cath
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- When you are asleep, the doctors put a tube in your mouth to help you breathe. They also put another small tube in your nose. This one goes down to your stomach to drain out any food or fluid that might come out during surgery. Your doctor will put a tube in your bladder to drain urine. The doctors will watch your blood pressure, heart rate, and breathing during the procedure.
- The doctor will make a long cut in the center of your chest so that the heart can be seen. A heart and lung bypass machine will be connected. This machine will act as your heart and lungs as your heart will need to be stopped for the surgery. The doctor will put the pump under your skin in the upper part of your belly.
- If you are having an LVAD, the doctor will connect a tube from the left ventricle of your heart to the pump and then to your aorta. If you are having an RVAD, the doctor will connect a tube from the right ventricle of your heart to the pump and then to the blood vessel that goes to your lungs.
- The doctor will attach a small tube to the pump. This tube goes out to your skin and connects the pump to the controller.
- Once the pump works, the doctors will give you a drug to start your heart again. You will be taken off the heart-lung machine.
- Your doctor will close your chest and your cut with stitches or staples and cover it with clean bandages.
- This procedure takes 4 to 6 hours.
What happens after the procedure?
- You will go to the Intensive Care Unit after surgery and the staff will watch you closely. You may need to stay there for a few days for careful monitoring of your condition.
- The staff will take out your breathing tube when you are awake and strong enough to breathe. You may have a sore throat afterwards.
- You will feel pain after the surgery. The staff will give you drugs to ease the pain.
- You will be moved to a regular room when your condition is stable.
- Within a day or two, you will get out of bed to a chair. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear.
- You may need to stay in the hospital for a few weeks or longer if you have problems.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Your healthcare team will help you learn how to take care of yourself, and the VAD. You will learn about what drugs to take and when to follow up with the doctor. Be sure you understand what to do in case of an emergency. It is good if another adult in your household learns these things as well.
- Your healthcare team will help you adjust to going home. You may be allowed to go home for a few hours during the day and return to the hospital for the night. If these trips go well, your doctor may discharge you from the hospital.
- Take your drugs as directed by your doctor. Follow your doctors orders.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages. Keep them clean and dry. Always wash your hands before and after touching them.
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, and sex
- Protect your chest from any blow or impact.
- Always sit up straight. Do not bend over with your chest.
- Sleep in a reclined position.
- Ask your doctor what activities are good for you. Supervised exercise is good for your overall health.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- Your doctor may send you to a cardiac rehab center for more heart and physical care.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
What lifestyle changes are needed?
- Always wear your medical ID or bracelet when you go out of your house. The staff may give you a card that tells about your VAD. Carry this in your wallet.
- Notify airport personnel that you have a VAD before going through the security process.
What problems could happen?
- Heart attack or stroke
- Blood clot formation
- Bleeding
- Infection
- Weakening of the heart
- Device malfunction
- Injury to nearby organs or tissues
When do I need to call the doctor?
Activate the emergency medical system right away if you have signs of a heart attack or stroke. Call 911 in the United States or Canada. The sooner treatment begins, the better your chances for recovery. Call for emergency help right away if you have: ‚
- Signs of heart attack:
- Chest pain
- Trouble breathing
- Fast heartbeat
- Feeling dizzy
- Signs of stroke:
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Helpful tips
- Join a support group to know other people who have coped with this condition.
- Talk with your doctor about your worries and fears.
Where can I learn more?
National Heart Lung and Blood Institute ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/vad/ ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚