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If you’ve recently suffered from a heart attack, had heart surgery, or are in heart failure, your doctor may have discussed implanting a ventricular assist device (VAD) into your heart. This mechanical device helps a vulnerable heart pump blood to the body, supporting the heart’s function.

Doctors implant a VAD into your chest and connect it to machinery located outside your body. This new equipment comes with some limitations and takes some time to get used to.

Here’s what you should know about VADs, including some lifestyle tips for living with one.

What Is a Ventricular Assist Device (VAD)?

VADs are mechanical devices that connect to the heart to support its functioning during heart failure.

Doctors often use VADs as a bridge to a heart transplant when medical treatment or surgery are no longer options. After implantation, a VAD sustains your heart while you wait for your transplant. In some cases, VADs allow you to live a more normal life outside the hospital while you wait for your new heart.

For others with end-stage heart failure, a VAD may provide permanent treatment. This is known as destination therapy.

VADs can also provide your heart with temporary support after a heart attack or heart surgery. This is known as bridge-to-recovery therapy.

Along with heart failure support, VADS can be useful for other conditions, including:

• Cardiogenic shock.
• Cardiomyopathy.
• Congenital heart disease.
• Heart attack leading to heart failure.

There are several types of VADS, including:

• Biventricular assist devices (BiVADs) — These support the pumping function of the left and right sides of your heart.
• Left ventricular assist devices (LVADs) — LVADs are the most common type of VAD. They support the pumping function of the left ventricle, the heart’s major pumping chamber.
• Right ventricular assist devices (RVADs) — RVADs support the pumping function of the right side of your heart.
• Pediatric VADs — These are smaller VADs that doctors can customize for use in young and growing children.

What Happens During VAD Surgery?

Having a VAD implanted is a major surgery that requires several tests and imaging. Once you qualify for VAD surgery, your doctor will review the risks and benefits of the procedure. They will also discuss which device is best for your situation.

Having a VAD requires lifestyle changes. It’s important to understand the risks and changes from this procedure, including:

• Activity limitations.
• Body image issues.
• Bleeding and blood clots.
• Depending on caregivers for support.
• Infection.
• Loss of sleep or insomnia.
• Mental health issues, including anxiety and depression.
• Right heart failure, if implanting an LVAD.
• Taking blood thinners and possibly other medications.

VAD implantation procedures can take anywhere from four to six hours. While minimally invasive techniques may be an option in some cases, most VAD procedures require open heart surgery.

During the procedure, you will be under general anesthesia and connected to a ventilator. A heart-lung bypass machine will maintain blood flow to your body throughout the surgery.

Your surgeon will make an incision in your chest to access your heart. They will then implant the device and ensure it is working before closing the incision.

What is the Recovery Process for VAD Surgery?

After the surgery, you will spend time in the intensive care unit (ICU). You will likely need ventilator support as your body adjusts to the new device. The ventilator helps you breathe as you recover.

When ready, you’ll move into a hospital room, where your care team will help you prepare to go home. The length of stay varies for each person, but you can expect to spend two to three weeks in the hospital after surgery. During this time, you’ll learn how to care for yourself and your device.

When you’re able to go home, you’ll need to have a family member or care partner available to help you for a few weeks. Make sure to follow all instructions for maintenance, medications, exercise, and healthy eating. This will ensure you get the best results with your new device.

What Should I Know About Daily Life After VAD Surgery?

Living with a VAD once you return home from the hospital can take time and patience. You may have to change your lifestyle quite a bit to accommodate your new limitations.

The first important reminder about living with a VAD is taking blood thinners, either orally or sometimes by injection. Blood thinners help prevent blood clots and decrease the likelihood of stroke or thrombosis (blood clots) after surgery. These medications must be taken for the entire time you have the VAD implanted.

Another important reminder is that your VAD requires electricity to work. Your device will need to be plugged into a three-pronged outlet or connected to a battery pack with enough energy to sustain you.

This power need can greatly limit your movements. It requires extra precautions and forethought to charge batteries when leaving the house or traveling.

You should also expect to be cared for 24/7 for several weeks, even after being discharged from the hospital. Because VADs are inserted into weakened hearts, the body will take time recovering.

You may need help:

• Changing your bandages or dressings at the surgical site, including the use of cleaning solution, sterile gauze sheets, and transparent dressing covers.
• Checking the safety and efficiency of VAD equipment, including ensuring the machine has electricity.
• Driving, as you cannot drive a vehicle until your chest is completely healed.
• Managing medications, including blood thinners.
• Managing nutrition and hydration, including monitoring vitamin K and limiting salt intake.
• With household chores, including cooking, cleaning, dressing, moving around the house, and showering.

You may feel ashamed or down that your healing is taking a long time or that others need to help you. During this recovery time, it’s important that you rest and listen to your doctor’s aftercare instructions. That way, the VAD can help your heart’s functioning.

Changing VAD dressings

Your care team will instruct you and your at-home caregivers on how to clean your VAD site. They should provide you with the necessary materials.

Change VAD exit sites weekly or as needed. Talk with your care team for further instructions.

Eating with a VAD

Understanding your nutritional needs with a VAD is crucial for keeping your heart healthy. Some essential tips to follow when creating a diet plan include:

• Avoid overly processed foods — Such as fried foods, sugary drinks, and processed snacks — to promote a healthy heart.
• Eat nutrient-dense foods — Whole foods such as fresh fruits, vegetables, lean proteins, and whole grains should make up most of your meals.
• Get your vitamin K — Preventing blood clots is an important part of living with a VAD. Ensure you’re getting enough vitamin K by eating leafy greens, blueberries, and eggs.
• Hydrate appropriately — While you’re encouraged to drink plenty of fluids, you should monitor your intake to prevent overloading your body with water.
• Limit sodium intake — Salt can cause fluid retention.

Talk with your care team or ask for a referral to a nutritionist if you have questions about what to eat with a VAD.

Exercising with a VAD

Body movement is always encouraged, but it’s important to take special precautions and start slow. After surgery and a lengthy hospital stay, your body may take several weeks to regain enough energy to exercise.

You cannot take part in contact sports or swim with a VAD. Talk to your care team before starting any new exercises.

Begin slowly, with short-duration activities. Take your time increasing duration, frequency, and intensity.

Intimacy with a VAD

After you have recovered from surgery, you can continue being intimate. Find a comfortable position that doesn’t interfere with the equipment or cause excessive movement at your device’s exit site.

If you are of childbearing age and able to get pregnant, you must exercise extreme caution with contraception. You cannot be pregnant with any VAD, as you cannot be on blood thinners while pregnant.

Talk with your doctor about the right type of contraception for you. Ensure that you use it to prevent pregnancy.

Showering with a VAD

You can shower with a VAD after your incisions have healed. You must take proper protection measures to keep the equipment from getting wet.

Your care team will discuss and provide a special shower bag for bathing. Have a caregiver help you with this task until you feel confident using it on your own.

Traveling with a VAD

Once you have recovered from VAD implantation, you can travel anywhere you want. If traveling by plane, you may need to notify airport staff so you can bring your equipment through security. It’s also crucial to bring all equipment, medications, and dressing supplies when you travel, as well as enough battery support to last you for your travel day. If you cannot plug into a three-pronged outlet, you will need battery support.

Working with a VAD

Your care team will discuss returning to work with you, depending on the nature of your job. As long as your work requirements do not conflict with your restrictions and health status, you should be able to return to work after you recover.

What Should I Avoid With a VAD?

You must avoid certain activities with a VAD, including:

• Alcohol and cigarettes — A VAD supports a vulnerable heart, so you must avoid smoking and drinking to encourage recovery. If you’re addicted to cigarettes or have a substance use disorder, talk with your health care team before surgery. They can help you find resources for quitting.
• Contact sports — You must avoid any activity that involves or could involve forcefully contacting another person or the ground. This helps protect the VAD equipment.
• MRIs — VADs are electrical equipment that cannot be used in an MRI machine.
• Submerging in water — A VAD cannot be submerged in water. You must avoid swimming in any body of water, taking baths, and using hot tubs. For hygiene, you can take showers using proper VAD coverings.