UW Health Ventricular Assist Device User Guide

: June 16, 2024
: UW Health

Table of Contents

Things to Do
Things to Do
Things to Do
Things to Do
Things to Do
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UW Health Ventricular Assist Device

UW Health Ventricular Assist Device

Introduction

We look forward to welcoming you to UW Health for your Ventricular Assist Device (VAD) evaluation. Our VAD team takes pride in building a care plan tailored to your unique needs. We provide remarkable care for both adults and children.

The Heart

Before learning about a ventricular assist device (VAD), you need to know about heart failure. Heart failure can be caused by many things. Heart failure means that your heart muscle is weak. It does not pump as much blood as it should. This does not mean that your heart has stopped or is about to stop. It means your heart does not pump like it once did.

The picture below shows how the heart works normally. If it gets too weak, medicines and other treatments may not be enough.

About Ventricular Assist Devices (VADs)

VADs are mechanical pumps that can be surgically implanted into your heart to help push blood to your body.

The most common type of VAD is a left ventricular assist device (LVAD). This device supports your heart’s biggest chamber, the left ventricle. The LVAD is a small pump placed into the left ventricle to help pump blood to the rest your body. The pump is connected with a cord through your skin to equipment and power sources outside of your body.
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These devices can be used as either a short-term therapy while waiting for a heart transplant evaluation or as a permanent or long-term option to extend your life and help you feel better.

Your VAD Evaluation Visit

On average, the evaluation takes 2-4 days. This depends on testing that you have had in the past. It is meant to provide the team with a complete overview of your heart disease and specific needs. The evaluation includes tests and visits with our team to see if a VAD is a safe option for you. The heart transplant evaluation is a separate process.

The VAD evaluation will include many tests. These include:

Cardiac tests: echocardiogram, right heart catheterization, exercise stress test, EKG
Chest x-rays
Ultrasound of the arteries
Chest CT with contrast
Blood tests
Urine test
General health testing (dental exam, vaccines, colonoscopy)

Support Person Must Attend Evaluation Visit

Surgery is complex. A strong support system is important in helping you have a successful outcome. We require that you have a primary support person who is 18 years of age or older. This could be a family member, friend, or guardian. This person must attend your evaluation visit. They must also be willing and able to provide in person support as you prepare for and recover from surgery and the rest of your time in the VAD program.

To prepare for your evaluation, we have enclosed:

Patient and support expectations These are documents that explain how we want patients and their support person to partner with us in their care. Please read these documents with your family, friends, and other support persons.
Advance directives
These are legal forms that clearly state what actions to take if you can no longer make decisions for yourself. We strongly advise you to complete advance directives. If you have one, please bring a copy with you. We will add it to your medical record. We can help you complete these forms if you haven’t already.

What to Bring to Your Evaluation

At least one person you have identified for support

Copy of Advanced Directives if you have them filled out
Your insurance cards
An overnight bag with essential items. Some patients are admitted for conditions found during the evaluation.
A list of your current medicines and supplements or pill bottles. This list should include doses and why you take them. Also bring medicines you may need to take during your appointment
A list of questions you or your support person have for the team.
Snacks/sack lunch
Something to do (tablet, book, etc.)

Team Members

Surgeons
A heart surgeon meets with you and your family during the evaluation. They review your record, test results, and explain the surgery. They review the risks and benefits of surgery. The surgeon does the surgery and works with other doctors to manage your care after the surgery.

Cardiologists (Heart Doctors)
These doctors prescribe medicine for your heart failure. They help to decide if a ventricular assist device (VAD) is the next best option for you. They stay involved before surgery and after the implant.

Nurse Coordinators
Nurses coordinate your care during evaluation and before and after surgery.
They help to arrange tests and will contact your local doctors or other healthcare facilities as needed.

Social Workers
A social worker will meet with you at your evaluation. They will talk with you about your support plan, whether you use any alcohol or substances, how you cope, andc how well you will be able to follow important instructions. They can help you complete advance directives. They can also help to connect you with community resources.
You will need to learn more about your insurance plan. A person who gets a ventricular assist device (VAD) needs lifelong follow-up care and medicines. Learn about your co-pays and deductibles for clinic visits and tests. This will help you budget for this expense.

Clinical Dietitians
Clinical dietitians assess your nutritional status and your strength. They help you make a plan for good nutrition and exercise.

Physician Assistants and Nurse
Practitioners
These advanced practice providers care for you before and after your VAD implant surgery. They check on you as you recover and help to manage your medicines. They also help to plan for your discharge needs. You will see them in clinic before and after your surgery.

Other Services
Other services are available to help you and your family. For example, Interpreter Services help those who need translation.
Guest Services can help if you need short-term housing.

Tips for Talking with Your Health Care Provider

You and your health care team are working toward the same goal – good health for you.
Talk together about your health and any problems you may have. Here are a few tips to make the most of your time together.

Use clinic and hospital visits to learn how to best care for yourself. Ask questions.
Practice new skills. Get advice about what might work best for you.

Be a partner in making decisions. Ask about your options. Find out about pros and cons of any decision. Plan your care with the health care team and others who support you.

When you make an appointment, ask if you need any tests before you come in.
You may need to wait to eat or drink until after a test is done. Ask if you can do the test before your appointment. You may be able to get the results during your clinic visit.

Prepare for your visit. Think about the reason for your clinic visit. Write down what you want to tell your provider. Write down any questions you have. Ask the person who comes with you to help keep track of questions and answers.

Be clear about your health problem and how you feel. Before your clinic visit, you may want to write down:

How long you have had your health problem,
What you have done about it,
How your health problem changed or stayed the same,
What makes it better or worse

Share what you have been doing about your health problem. If you have been treating yourself or changed the treatment, tell your provider. To best help you, your team needs to know how you are caring for yourself.

Listen carefully and ask questions. If you don’t understand, ask questions. Ask for more information if you need it. Take notes or ask for a written sheet if this would help you. Ask your health care provider:

What your health problem is
What caused it
What you should do about your health problem
When it will improve
If you need a follow-up visit

Make sure you know and agree with the plan.

Repeat what you have heard to make sure you understand what was said.
Make sure the instructions are right for you. If they aren’t, tell your provider. The plan can be changed to better meet your needs.
Understand side effects and what to expect from any new medicines.
Find out who to call for questions after you go home.
Take your after-visit summary sheet at the end of a clinic visit. You can also find it in MyChart.

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 © 1/2024. University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#8319.

Before Evaluation

Coordinator reviews information with your doctor and contacts you to plan evaluation
Approval is needed from insurance company for evaluation and surgery
The evaluation will be scheduled, including meetings and tests
Information and evaluation schedule will be sent to you

Things to Do

Review itinerary and pre-evaluation education
Complete any questionnaires or forms
Add care team contact information to your phone

Evaluation

Usually lasts 2-4 days
Support person must attend
Includes testing, lab work, and meetings with each member of the team
No formal decision is made until after evaluation is done

Things to Do

Prepare overnight bag in case of admission
Bring any completed paperwork or advanced directive
Plan to be early and review itinerary before arrival

Preparing for Surgery

Expect pre-surgery education and questionnaires
You will be admitted to the hospital before surgery
Medical team will ensure you are ready for surgery
B1ing a list of questions

Things to Do

Bring electric company information and account number
Review evaluation documents for what lo pack
Ensure you are established with Primary Care Provider (PCP)

Surgery

You will stay in the hospital after surgery to heal and to learn
You and your support person will lcam about the care of the device and sterile dressing changes
You will be tested on the VAD equipment, troubleshooting, and dressing changes

Things to Do

Education sessions will be scheduled with support person for 2 hours a day, Monday- Friday from 8:00 AM- 3:00 PM until successful with testing
Study education material on your own time

Follow-up