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Left ventricular assist devices (LVADs) have saved and extended the lives of thousands of patients with heart failure. These small, surgically-implanted mechanical pumps have internal and external pieces that help the heart pump blood throughout the body when the heart is too weak to pump on its own. While LVADs are revolutionary in heart failure care, the external components carry a risk of infection—the leading cause of hospital readmission for LVAD patients.
A large part of my role as a VAD coordinator is helping patients understand how to care for their devices and their bodies to prevent infection. I work with a 50-person team who is dedicated to every aspect of LVAD patient care. We do extensive work with patients to prevent LVAD infection, much of which involves sterile care at the exit site.
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How we help LVAD patients avoid dangerous infections
We developed a website, MyLVAD.com, which includes LVAD Dos and Don'ts for daily living and infection control:
- Change your exit site dressing as instructed by your LVAD team
- Clean and inspect your equipment daily
- Notify your LVAD team immediately if you see any signs of injury, trauma or infection
- Use the MyLVAD.com community forums to meet and share your experiences with other LVAD patients and caregivers
- Disconnect the driveline from the controller (under normal circumstances)
- Kink, bend or pull your driveline
- Sleep on your stomach
- Take a bath or swim
Related reading: Living with an LVAD: 5 tips to make it easier
The driveline requires special care to prevent it from catching on something and to keep it from moving around too much. These precautions are important because if the driveline is pulled or snagged, the skin could tear at the exit site, which can increase the risk for infection. VAD companies make canvas bags and straps to help support the equipment. We help patients learn to adapt the way they do daily activities to prevent their external components from catching on things like doorknobs when they’re walking by.
Our patients receive special site dressing kits to keep the driveline and surrounding area sterile. The kits have securement devices to hold the driveline from accidental pulling or moving around. Patients are given two kits per week with everything they need to keep the area secure and clean. There are steps to change the dressing safely, and our team will make sure caregivers and patients are confident in the process.
We do extensive work with patients to prevent #LVAD infection. As part of that care, we’ve developed a website, MyLVAD.com, which includes LVAD Dos and Don'ts for daily living. bit.ly/2K0Vb9E via @MedStarWHCClick to Tweet
LVADs have come a long way in the past 30 years. They are much smaller than they were even 10 years ago. It’s possible that in the future the internal pump would not need external components. Until then, we’ll continue to educate LVAD patients and their families to reduce infection risk and keep them out of the hospital.