Recovery time after ventricular assist device (VAD) surgery depends a lot on your condition before the surgery.
If you had severe heart disease for a while before getting the VAD, your body might be weak and your lungs may not work very well. Thus, you may still need a ventilator (a machine that supports breathing) for several days after surgery. You also may need to continue getting nutrition through a feeding tube.
When you first wake up from VAD surgery, you'll be in the hospital's intensive care unit (ICU). An intravenous (IV) tube will provide you with fluid and nutrition. You'll have a tube in your bladder to drain urine and tubes to drain blood and fluid from your chest and heart.
After a few days or more, depending on how quickly your body recovers, you'll move to a regular hospital room. Nurses who have experience with VADs will take care of you.
The nurses will help you get out of bed, sit, and walk around. As you get stronger, you'll be able to go to the bathroom on your own and have a regular diet. The feeding and urine tubes will be removed. You'll also be able to take a shower. You'll learn how to care for your VAD while bathing.
In the hospital, nurses and physical therapists will help you gain your strength through a gradual increase in activity. You'll also learn how to care for your VAD at home.
Having family or friends visit you at the hospital can be very helpful. They can assist you with many activities. They also can learn about caring for the VAD so they can help you at home.
After VAD surgery, you'll need to watch for signs of infection. These signs might include soreness over the VAD site, fluid draining from the site where the tubes or cable exit the skin, or fever. If you have these signs, tell your doctor right away.
You may take antibiotics before the surgery and for a few days after the surgery. Antibiotics can lower your risk for infection.
With most VADs, doctors also prescribe anticlotting medicines, such as warfarin (Coumadin®) and aspirin. These medicines help prevent blood clots from forming in your heart or the VAD.
When you have a device implanted in your body, the risk of blood clots increases. You'll likely need to take anticlotting medicines for as long as you have the VAD. You'll also have periodic blood tests to make sure the medicines are working well.
Take all of your medicines as your doctor prescribes. Let your doctor know whether you have any side effects.
After the initial recovery from VAD surgery, you'll begin to get ready to go home. Your health care team will help prepare you for the transition.
The team may include a heart surgeon, cardiologist (heart specialist), critical care nurse, physical therapist, dietitian, and social worker.
The team will help you gradually adjust to living at home with the VAD. You'll leave the hospital and go home for a few hours and then come back. Next, you may go home for a whole day and come back to the hospital to sleep.
If these trips go well, your doctor might discharge you from the hospital. If you haven't recovered your strength enough, you might go to a special care facility for up to 2 weeks. This allows your medical team to make sure you're ready to go home.
Your medical team also will teach you how to live with a VAD. You may get some of this information before your surgery. You'll learn how to care for the VAD, what to do in case the device gives a warning that it's not working well, and how to do normal daily activities like bathing.
For more information, go to "What To Expect Before Ventricular Assist Device Surgery."
When you go home after VAD surgery, you'll likely be able to return to most of your normal daily activities. You might be able to return to work, engage in hobbies and sexual activity, and drive. Your medical team will advise you on the level of activity that's safe for you.
If you're waiting for a heart transplant, you'll need to stay within 2 hours of the hospital in case a donor heart becomes available.
If you're not waiting for a transplant and want to travel, your medical team can advise you about any special steps you need to take. People who have VADs can fly in airplanes and use all other forms of transportation.
While you recover from VAD surgery, getting good nutrition is important. Talk to your medical team about following a proper eating plan for recovery.
Supervised exercise also is important to give your body the strength it needs to recover. During the time when your heart wasn't working well (before surgery), the muscles in your body weakened. Building up the muscles again will allow you to do more activities and feel less tired.
Your health care team may recommend cardiac rehabilitation (rehab). Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems.
Rehab programs include exercise training, education on heart healthy living, and counseling to reduce stress and help you return to a more active life.
You and your doctor will schedule followup medical visits. This will help your doctor track how you're doing.
After you leave the hospital, your doctor may advise you to visit an outpatient clinic weekly for the first month. After that, you may go every other week and then every other month for a certain amount of time.
If you're on the waiting list for a heart transplant, you'll stay in close contact with the transplant center. Most donor hearts must be transplanted within 4 hours after removal from the donor.
Some heart transplant centers give you a pager so the center can contact you at any time. You need to be prepared to arrive at the hospital within 2 hours of being notified about a donor heart.
Getting a VAD may cause fear, anxiety, and stress. If you're waiting for a heart transplant, you may worry that the VAD won't keep you alive long enough to get a new heart. You may feel overwhelmed or depressed.
All of these feelings are normal for someone going through major heart surgery. Talk about how you feel with your health care team. Talking to a professional counselor also might help.
If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.
Having family and friends around for support also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. They can play an important role in caring for you after you go home.
Clinical trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective for humans. To find clinical trials that are currently underway for Ventricular Assist Device, visit www.clinicaltrials.gov.
November 20, 2013
Gary H. Gibbons
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