Transcript Heartware - University of Wisconsin Hospital and Clinics

Community Preparation for
Caring for Mechanical Circulatory
Device Patients
University of Wisconsin Hospital
And Clinics
Ventricular Assist Device Program
Mechanical Circulatory Support
Device Overview
• MCDSs are devices to support the failing heart
(one side or both)
• Most MCDS patients are anticoagulated with
Coumadin and Aspirin
• All MCDSs have:
– Pump (implanted inside the patient’s chest)
– Computer to control the settings/ display VAD
performance readings
– Power source: batteries or console connected to AC
power
Heartware HVAD Components
Small pump attaches
directly to heart
Thin, flexible driveline
cable exits skin
A small controller &
batteries run the
pump
Heartware HVAD Readings
3 Readings:
Flow= cardiac output from the pump
–
Target varies by patient
Speed= how fast pump is running rpm
range 2400-3200 rpm
Power= how much watts it takes to run the pump
- normal is < 8 watts
Heartware HVAD Care Overview
• Cannot palpate a pulse
• Pulse oximeter may/ may not work
• Need to assess if pump is running: listen over
the point of maximal impulse (PMI) area for a
consistent mechanical hum
• Blood pressure: need a Doppler and
sphygmomanometer
– result is considered a MAP
– acceptable MAP 60-85 mmHg
Heartware HVAD Care Overview
• EKG conduction-looks normal
– does not impact VAD function unless RV fails
– VAD will continue to receive blood supply until RV
fails or pulmonary hypertension
– Most of these patients have an ICD/ pacer. Some patients’
ICDs are off to avoid inappropriate shocks.
– Most VAD patients tolerate the arrhythmias well and may
have little symptoms for period of time.
• Assess for patient’s tolerance of situation (if able).
Ask for symptoms: lightheadedness, shortness of
breath, palpitations, bloating, pain (anywhere),
fever, chills, diaphoresis
Heartware HVAD Controller Faceplate
EMERGENCY CARE
• Call implant hospital: 608-263-6400 and ask for HEART
FAILURE ATTENDING ON CALL
• Still need to follow Airway Breathing of ABC’s
• √ VAD stopped (listen over PMI area for consistent
mechanical hum). If stopped significant risk for clot
inside MCDS and thromboembolize.
• NO CHEST COMPRESSIONS
• Defibrillation- STANDARD METHOD
• Heparin bolus if VAD stopped (contact implant hospital
first)
Contacts
608-263-6400 (Paging Operator)
• Heart Failure Attending
• Ventricular Assist Device Coordinator (nonemergency)