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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Cardiology, Cardiovascular Surgery

Homeward Bound after a Ventricular Device Implant (7892)

Homeward Bound after a Ventricular Device Implant (7892) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cardiology, Cardiovascular Surgery

7892

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Homeward Bound after a Ventricular Device Implant

Reminder: The patient and support person(s) can expect to stay in the hospital 10-14 days. They
will learn how to care for the patient and their Ventricular Assist Device at home.
Who will be present on the day of discharge?
A family member or support person(s) will be present the day of discharge to receive home
instructions.
What occurs on the day of discharge?
These are discussed the day of discharge:
Medicine: The patient will receive prescriptions for medicines and instruction on how to take the
medicines. The medicines will be different than what the patient was taking before the
Ventricular Assist Device implant. It is important for the patient to remember the names, doses,
and times of their medicines. The patient is instructed not to take medicine they were taking
before surgery, unless instructed by a Ventricular Assist Device team member. It is important for
the patient to bring their medical insurance card to their pharmacy when filling and picking up
medicine prescriptions.
Transportation: The patient needs a family member or support person(s) to drive them home.
Travel help is needed for the patient, until told otherwise by the Ventricular Assist Device team.
Support Person(s): A family member or support person(s) needs to stay with the patient for at
least 2 weeks after discharge from the hospital. This stay includes a 2-4 day stay in the Madison
area right after discharge if needed. The support person(s) will need to transport the patient to
and from clinic visits and other appointments during this time.
Follow-up Visits: The first clinic visit will be scheduled before discharge. The first follow-up
visit is 2-3 days after discharge. At this visit, sutures holding the driveline in place may be
removed. Five weeks after discharge, the patient will meet with the cardiac surgeon. At 8 weeks,
the patient will meet with the heart failure doctor.
Incision Care: At discharge, the only dressing needed is the dressing at the site of the driveline.
On all other incisions, a dressing is only needed if drainage is present. It is important to keep
incisions clean and dry. Do not apply ointments, powders, or lotions to the incisions. At first the
incisions may be red and swollen. This will lessen as the incision heals.

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Care for the surgical incisions: Wash with warm non-scented soap and water. The incision
must be patted dry. Do not rub the incisions until they are completely healed. Do not apply
ointment or creams to this incision.
Care for the driveline: The patient and support person(s) will learn to care for the driveline.
There is a special method called sterile technique used to care for the driveline. Follow
instructions given to you.
Signs of Infection: Contact a Ventricular Assist Device Coordinator member with any signs of
infection or incision irregularities. Signs of infection include:
ξ Increased redness, warmth, and soreness
ξ Chills and heavy sweating
ξ Loss of hunger or weight loss
ξ Thick yellow drainage
ξ Persistent fever (Temperature greater than 100.5 θ F)
Record Requirements: The patient is required to monitor their weight daily. It is required for
the patient to record their weight, systems check, and Ventricular Assist Device numbers on a
document or spreadsheet as directed by the Ventricular Assist Device team.
Fluid Restriction: The patient will need to restrict fluid, and follow a low salt diet. The doctor
often prescribes a water pill (diuretic) after surgery. Restricting fluids and decreasing salt will
help decrease swelling in all extremities and in turn, ease the patients breathing efforts.
Activity level and restrictions: As the patient heals, they will feel stronger and more
independent. It will take weeks and sometimes months to feel strong. It is important to balance
activity with rest and sleep. Deep breathing and coughing help the lungs recover. The patient will
deep breath and cough with a machine called incentive spirometer after discharge for 3 weeks.
Patients can be as active as they feel they can be; they know their body the best. Call the
Ventricular Assist Device coordinator if you have questions or concerns.
General Restrictions: All patients have activity restrictions after a Ventricular Assist Device
implant. It takes about 12 weeks for the bone in your chest to completely heal. These
restrictions apply for a 6 week time period or until doctor approval after implantation:
ξ Eight pound weight restriction or the weight of a gallon of milk.
ξ Shoulders should not be flexed or extended beyond 90 degrees.
ξ Do not push or pull with arms when moving in or out of bed.
ξ Avoid reaching too far across the body.
ξ Do not hold breath during activity.
ξ Brace the chest when coughing or sneezing.
ξ Avoid long periods of shoulder activity.

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ξ Do not repeat motions that cause the chest to pull or stretch.
ξ Report any clicking or popping noises around your breastbone to your surgeon.
Driving Restrictions: Approval from the surgeon or heart failure doctor must be granted before
the patient can drive a motorized vehicle. This includes cars, trucks, ATV’s, boats, motorcycles,
and dirt bikes.
Other Restricted Activities: Avoid twisting motions and heavy lifting until directed by the
surgeon or Ventricular Assist Device team. The activities to avoid include:
ξ Snow shoveling
ξ Lawn mowing
ξ Golf
ξ Tennis
ξ Hunting
ξ Fishing
ξ Running
ξ Bike riding
ξ Motorcycle riding
ξ Contact sport (e.g., soccer and football)
ξ Weight lifting
ξ Bowling
ξ Vacuuming and sweeping
Approved Activities: There are many activities that the patient can do while they are healing.
Below are examples of light weight activities:
ξ Light housework
ξ Visiting with friends
ξ Walking
ξ Shopping
Dental or Surgical Appointment: Take antibiotics before all dental work (cleaning), surgery,
and major test. The patient’s dentist or doctor can order the antibiotics for them. Always take
them before the visit.
Return to work: The Ventricular Assist Device social worker will complete all needed
paperwork about employment for the patient and support person(s). It is important to bring the
paperwork to the hospital before discharge. You should discuss this with your VAD team.
Common Experiences: These are some common patient experiences:

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Shortness of Breath: Many patients feel shortness of breath. This occurs when extra water is in
the body, anemia, or stress. Having shortness of breath with activity is common. Call your VAD
coordinator if the shortness of breath gets worse.
Decreased Appetite: Patient may have deceased appetite or notice that food tastes different. The
food can have a metallic or bitter taste. Decreased appetite may be caused by medicines used
during the surgery, such as anesthesia. Eating small meals throughout the day may help to
prevent feeling full quickly. The patient should eat what they can, while sticking to a low salt
diet and restricting fluids. Protein is needed for healing. It is helpful to eat high protein meals.
Any appetite changes or taste changes should return to normal a few weeks after the implant.
Loss of Sleep: Patients often have sleeping problems. They have trouble falling asleep or staying
asleep. Patients can have strange or vivid dreams. There is no known reason for any of these.
Naps or periods of rest are important in the first few weeks after discharge. Most patients find
their sleeping problems go away in a few weeks. A sleep aid may be helpful for a short period of
time. Ask the Ventricular Assist Device team about medicines if sleeping is a problem.
Changes in Mood: Changes in mood, such as feeling low or depressed, are common. It is due to
stress after surgery. It is best for the patient to share their thoughts and feelings with another
person. Patients with a strong support system tend to recover more quickly. It may take several
weeks for patients to feel better. If problems with coping exist, talk with the Ventricular Assist
Device team.
When to call for Help: It is important to know who and when to call for help.
Call 911 when the patient:
ξ Has chest pain that is different than incisional pain.
ξ Has chest pain that feels like angina.
ξ Has severe shortness of breath.
ξ Has a faster irregular heart beat more than 10 minutes while at rest.
ξ Is fainting or feels like they are going to faint.
ξ Is unconscious .
ξ Is not responding to commands.
Call the Ventricular Assist Device coordinator when the patient:
ξ Feels short of breath.
ξ Legs and/or feet are swollen.
ξ Has a Weight that goes up or down by 2 pounds in 1 day.
ξ Has a Weight that goes up or down by 5 pounds in 1 week.
ξ Has any sign of infection.

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Phone Numbers: The patient should record the phone number of their surgeon.
The phone numbers for the surgeons during business hours (Weekdays 8:00 AM to 4:30 PM):
ξ Dr. Takushi Kohmoto 608-262-3858
ξ Dr. Lucian Lozonschi 608-262-3858
ξ Dr. Satoru Osaki 608-263-0439
ξ Dr. Paul Tang 608-263-1407
After hours/weekend/holiday: 608-263-6400. This will get the paging operator. Ask for the
Ventricular Assist Device coordinator or heart failure attending on call. The patient will leave
their name and phone number with an area code. The attending will return the call.
Out of the Area: 1-800-323-8942. This will get the paging operator. Ask for the Ventricular
Assist Device coordinator or heart failure attending on call. The patient should leave their name
and phone number with an area code. The attending will return the call.
Appointment Questions: 608-263-1530. Please call the Cardiology Clinic during regular
business hours (weekdays 8:00 AM to 4:30 PM).



















Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7892