Scripps provides monthly LVAD informational sessions for you to learn more about this treatment option. These sessions are led by a mechanical circulatory support (MCS) nurse practitioner and include a cardiothoracic surgeon or heart failure cardiologist who is available to answer questions.
How do I prepare for my first appointment with a heart failure specialist?
You’ll meet our heart failure team, including a heart failure physician and a nurse practitioner/physician assistant. We will review your medical history and any medical test results. During the visit, you will receive education about your condition, recommendations about changes to your diet and lifestyle, and you may have your medications adjusted and other tests ordered.
We usually perform an echocardiogram (ultrasound imaging of the heart) to measure your heart and valve function. We also obtain an electrocardiogram (EKG) to assess the rhythm of your heart. If you have a cardiac defibrillator or pacemaker, we may check your device to make sure it is working appropriately. We may ask you to have blood drawn at our laboratory to check your kidney and liver function.
To prepare for your appointment:
- Please bring your medication list and the actual pill bottles for those medications.
- Bring any test results, including laboratory tests. It is best to obtain the images on CD for echocardiograms, angiograms and stress tests.
- We usually obtain notes from your physician beforehand, but encourage you to bring any medical documentation available to you.
- If you need any diagnostic tests, our clinic will help you set up appointments.
- Plan to be at the clinic for one hour or longer.
Depending on the severity of your condition, a number of diagnostic tests may be performed after your appointment, including exercise stress testing (VO2 max testing) and cardiac catheterization.
Open heart surgery for LVAD implant typically lasts from 4 to 6 hours. During LVAD surgery, a cardiothoracic surgeon enters the patient’s chest through an incision of the skin and opening of the breastbone.
The patient is placed on a heart-lung machine to fully support the heart and lung function while the LVAD is being implanted. The device is implanted on the left ventricular chamber of the patient’s heart via an inflow tube called a cannula.
Blood from the heart is pumped through an outflow cannula to the main artery (aorta) responsible for distributing blood to the entire body. The LVAD motor rests under the patient’s rib cage. A thin cord called a driveline runs from the LVAD motor through a tiny opening in the skin and connects to the controller and batteries outside the patient’s body.
LVAD batteries are recharged nightly when plugged into a power module.
Once the device is implanted, pump speed is slowly increased while the flow on the heart-lung machine is slowly decreased. When the LVAD is completely supporting the heart, the heart-lung machine is discontinued and the surgery is completed with closure of the chest incision.
After LVAD surgery is complete, most patients generally spend three to five days recovering in the state-of-the-art intensive care unit (ICU) at Prebys Cardiovascular Institute, and then move to a regular hospital room for another two to three weeks.
During this time, our physical and occupational therapists and dietitians will work with you to speed up your recovery process. We will continue to educate you and your care partner about caring for the LVAD, and your care partner will participate in driveline dressing changes with the LVAD coordinator.
Depending on your strength and overall needs you will either go home or to an inpatient rehabilitation program following your hospital stay. At the rehab facility, we focus on helping you build your strength and prepare to go home. You and your care partner will also have the chance to finish up any education about LVAD care and driveline dressing changes.
When you are discharged from the hospital or rehab facility, you will need to have a care partner with you 24 hours a day until you are able to safely care for yourself completely. The caregiver will continue to do the driveline dressing changes three times a week at home.
If you are from out of town, you should plan to remain in the San Diego area for one to three months after leaving rehab.
You will be seen in the LVAD clinic twice a week for the first few weeks. After that, your LVAD coordinator will review your scheduled clinic visits with you and your caregiver.
In addition, most patients will attend a cardiac rehabilitation program, where you can exercise and build strength in a medically supervised setting.
To learn more, view our frequently asked questions about LVAD.