Transcript Thoratec TLC-II

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
•Components
•VAD readings
•Care Overview
•Emergency Care
Thoratec TLC-II
• Can be used for RV, LV
or both
• Can be implanted or
paracorporeal
• Pulsatile VAD (can hear
it running)
• Sterile dressing over
cannula exit sites
• Each VAD has 2
mechanical valves
Thoratec TLC-II VAD Components
Inflow cannula
Outflow cannula
Thoratec TLC-II Control Panel
Thoratec TLC-II Care Overview
• Can palpate a pulse
• Need to assess if pump if running: listen for
mechanical valve clicking and the noise of
console working (BOTH NEED TO BE HEARD)
• Blood pressure:
– Keep SBP< 140
– Non-invasive blood pressure cuffs will work
Thoratec TLC-II Care Overview (cont’d)
• EKG conduction is not affected and arrhythmias
maybe tolerated including VT/ VF
– Most of these patients have an ICD/ pacer. Some patients’
ICDs are off to avoid inappropriate shocks.
– Most VAD patients tolerate the arrhythmias 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
Emergency Care- Thoratec
• √ VAD stopped (listen for valve clicking and console
running). If stopped significant risk for clot inside
MCDS and thromboembolize.
• NO CHEST COMPRESSIONS
• Defibrillation- STANDARD METHOD
• Heparin bolus if VAD stopped (contact attending
cardiac surgeon)
• Hand pumps can be used in case of console failure.
RVAD needs to be pumped < then LVAD.