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May 25, 2023

10 Essential Points for Patient Preparing for HeartMate 3 LVAD Procedure and Surgery

Are you preparing for a HeartMate 3 LVAD procedure or surgery? It's essential that you are well-informed before taking this step in your health journey. Whether you're a patient, caregiver, or healthcare provider, this guide will provide the basics of what you need to know about the HeartMate 3 LVAD.

We'll be going over 10 essential points for patient education about this device and the related procedures. We'll discuss patient selection, preparation for the procedure, technical aspects of surgery, immediate post-operative care steps, post-discharge instructions when you're sent home with the device, what to do when alarms are triggered, and advice regarding wound care. Together we'll review each in detail so by the end of this post you'll have all you need to know about HeartMate 3 LVADs. Let's get started!

HeartMate 3 LVAD Procedure and Surgery

Patient Selection Criteria for HeartMate 3 LVAD

When it comes to selecting patients for the HeartMate 3 LVAD, patient selection criteria is limited to those with severe systolic left ventricular (LV) dysfunction. This can be measured with either an ejection fraction (EF) < 25%, or cardiac index <2.2L/min/m2. In terms of risk scores, these are also taken into account when determining whether an LVAD is the right choice for patient such as the Heartmate 3 risk score.

It's also important to note that absolute pulmonary pressure (PP) or resistance (Rp) do not always serve as important criteria for LVAD selection; instead, it's more about the LV and RV performance itself when making the decision. In addition, other clinical parameters such as renal function and pulmonary hypertension should also be included when deciding who is best suited to receive the HeartMate 3 LVAD.

Preparing for Your HeartMate 3 LVAD Surgery

Preparing for your HeartMate 3 LVAD surgery means understanding what to expect on the day of the procedure, as well as knowing how to properly prepare leading up to the surgery. Before deciding if a LVAD is right for you, the patient selection process must be completed. Your doctor will review your medical history, lifestyle and activity level in order to discuss any risks associated with implanting a LVAD.

Your doctor will then take you through the technical aspects of surgery. Implantation of a LVAD requires meticulous technique and may be performed via standard median sternotomy or left antero-lateral thoracotomy. As you prepare for surgery, it'sa good idea to ask questions about what will happen on the day off and learn how to respond to alarms and other warning signs that may need immediate attention. Your doctor can also provide advice on wound care and how best to prepare your body for surgery.

Knowing what to expect before your HeartMate 3 LVAD procedure helps ensure that everything goes as smoothly as possible. Be sure to speak up if you have any questions or concerns so that you can feel confident going into your surgery.

How the HeartMate 3 LVAD Works: The Technical Aspects

When it comes to the HeartMate 3 LVAD and the technical aspects of surgery, there are essential points that your doctor should go over with you before you proceed.

The HeartMate 3 LVAD is a fully magnetically levitated left ventricular assist device. It includes Full MagLev Flow Technology in the pump and a contactless bearing technology. This consists of a rotor with passive magnets for drive.

What happens during the procedure:

  • Your surgeon will implant the LVAD through an incision in the chest, connecting it to both your heart and aorta.
  • An external controller and battery system are positioned outside your body, which allow you flexibility while controlling the pumps speed.
  • The wires used to power the implantable device travel through a variety of vessels around your body in order to keep them out of harm's way.
  • Connections between the device, wires and battery system create an airtight seal in order to prevent any potential infections.

This type of advanced technology makes it possible to have this lifechanging procedure with surgery, allowing you to recover faster than ever before.

Recovering After Your HeartMate 3 LVAD Surgery: Immediate Post-Op Care

For the first few days after your HeartMate 3 LVAD surgery, you'll be in the Intensive Care Unit (ICU) as you recover. During recovery, there are some key points related to your care and post-op management that are important to understand.

Firstly, intravenous medications will be weaned over the course of 5-7 days. During this time, healthcare professionals will monitor cardiac function of your left ventricle and heart rate regularly. Secondly, anticoagulation with warfarin begins immediately following the procedure. Also, parameters such as anticoagulation levels must be monitored closely until stabilized.

In addition, if complications arise post-surgery such as inflammatory response or venous thrombosis, inhaled nitric oxide and inhaled prostacyclin can be used to offer assistance. Finally, patients must also adhere to proper wound care which should include keeping the wound clean and dry at all times in order to prevent infection.

By understanding these essential points about HeartMate 3 LVAD recovery, you'll be better prepared for what comes next in the postoperative period of your procedure and surgery.

Caring for Your HeartMate 3 LVAD at Home: What to Expect After Discharge

Once you've gone through surgery and the immediate postoperative care, you're ready for discharge! This is an exciting time, but it's also important to be mindful of your LVAD and know how to care for it after leaving the hospital.

Here are some things to look out for on your discharge day:

  • Intravenous (IV) medications will be weaned off in the intensive care unit (ICU) over 4-5 days.
  • A cardiac rehabilitation program will be recommended by your doctor after you leave. It's important to take part in this program even after discharge, as it helps with recovery.
  • You'lllikely receive a phone call from a nurse practitioner for a non face-to-face assessment early on the day after discharge. This assessment will help make sure that you are complying with medication and LVAD driveline dressing changes.
  • Additionally, make sure to watch out for any alarm signals that may indicate any issue while taking care of your LVAD at home, such as if there is any obstruction or leakage in the driveline.
  • Finally, remember to keep an eye on incision sites, as they may need some wound care post op. Follow all instructions given by your healthcare team and always reach out with any questions or concerns!

Responding to HeartMate 3 LVAD Alarms and Troubleshooting Issues

It's important to understand how to respond to alarms and issues with your HeartMate 3 LVAD system. Most alarms require the patient to call the VAD Emergency Number for instructions, but some alarms indicate problems that can be addressed by the patient. To help you with this, there are a few manuals and resources available.

You can also find helpful information in the HeartMate 3 Pocket Guide, which has general information on the device and its components, as well as the Checklist of Alarms & Troubleshooting guidebook, which provides response recommendations for specific alerts associated with both controller systems.

These resources will help you understand more about how your HeartMate 3 LVAD works, so you're prepared if any emergency or error situations arise during your recovery process.

Caring for Your HeartMate 3 LVAD Drive Line Exit Site and Wound

Once you get home, it is important to pay special attention to caring for your drive line exit site and wound. Infection is a common complication after a HeartMate 3 LVAD implant. Chlorhexidine solution should be used for skin cleaning prior to dressing closures and sterile gauze sheets and transparent covering will be recommended.

For some, negative pressure wound therapy can be used to treat driveline infection. In addition, prophylactic antibiotics and daily wound care with a sterile silver-impregnated dressing should also be used. You'll need to keep the area clean to prevent infection and inflammation.

Be sure to notify your Care Team if you experience any signs of infection like increased wound drainage, redness or swelling around the exit site, warmth or tenderness on skin near the exit site, fever or chest pain increases near the exit site are all signs that you may need medical attention.

Living With Your HeartMate 3 LVAD: Diet, Activity, and Follow Up Care

Once you have your HeartMate 3 LVAD, you'll need to make changes to your lifestyle. You'll need to make sure that you follow a special diet and maintain regular physical activity. You'll also need to pay attention to follow-up care, including routine clinic visits and heeding any alarms your device may sound.

Diet

You will need to follow an enteric diet, which is the preferred method of artificial nutrition support in LVAD patients. This diet helps reduce the risk of infection by minimizing movement of bacteria from the gastrointestinal tract into the bloodstream. Eating mostly soft and/or liquid food can help reduce symptoms such as coughing or choking.

Activity

For patients with LVADs, being physically active is key. Your doctor will discuss an activity plan tailored to your individual needs and goals. You should plan on doing some kind of physical activity every day, such as walking slowly or riding a stationary bike for at least 10 minutes.

Follow Up Care

Patients with HeartMate 3 LVADs require regular follow up care which may include routine clinic visits, blood tests, echocardiograms, and other imaging tests in order tomonitor device performance and look for signs of infection or clotting in the circuit flow paths. Additionally, caregivers must be trained in helping you manage your LVAD and respond appropriately when alarms occur; they will also need to be trained in wound care so that they can adequately assess any skin rashes near the device insertion site on a regular basis.

Traveling With Your HeartMate 3 LVAD

Traveling with your HeartMate 3 LVAD is easy and safe, generally speaking. Of course, it's important to talk with your doctor before you travel as they are the best person to help you make decisions about what's safe for you.

But in general, traveling with an LVAD is much like traveling without one. You should drink non-caffeinated beverages while traveling and wear a medical alert bracelet in case of an emergency. Commercial air travel is deemed safe for those with stable patients on permanent VAD support, as well.

When it comes to long car rides and trips, here are a few tips to keep in mind:

  • Make sure you always have a charger on hand
  • Monitor your flow frequently
  • Be mindful of temperature changes if you're going somewhere warm or cold
  • If possible, bring a spare battery and drive belt when driving long distances
  • Make sure you can access care if needed at your destination

Additional Resources for HeartMate 3 LVAD Patients and Caregivers

The HeartMate 3 LVAD team can provide patient discharge education to help give you the skills and knowledge you need to manage the device. With this education, you and your caregiver(s) will be ready to take the device home.

By understanding what is expected of them, patients and caregivers are better equipped to make a successful transition from the hospital back home. Caregivers must be familiar with:

  • The operation of the device
  • Alarm management
  • Wound care
  • Infection prevention & control

Your care team will provide specific instructions personalized to your needs and lifestyle. The HeartMate 3 LVAD comes with resources including an HDE guidebook, patient DVD, website access and a personal support line—all focused on starting you off on the right foot as you make this transition.

By taking advantage of all these resources, patients and their caregivers can have peace of mind knowing they are well equipped for success with their HeartMate 3 LVAD.

Conclusion

The Heartmates 3 LVAD is a life-saving device, and it is important that you understand the 10 points of patient education provided here. From patient selection to responding to alarms, you need to be prepared for the procedure and for post-op care. It is essential to take the time to understand the technical aspects of the surgery, as well as the importance of wound care and understanding how to respond to alarms. When you are armed with the necessary information, you will be able to make the best decisions for your own health and wellbeing.