Knowing Your Device and
Understanding Surgery
Over the years, advanced technology has been used to develop devices to help patients diagnosed with heart failure. Many of these devices, although designed for adults, have been adapted for use in children. Let’s explore each device and what to expect before, during, and after surgery.
Over the years, advanced technology has been used to develop devices to help patients diagnosed
with heart failure. Many of these devices, although designed for adults, have been adapted for use
in children. Let’s explore each device and what to expect before, during, and after surgery.
1
Pacemaker/ICD
2
VADs
3
Pre-Transplant
4
CardioMEMS™
Overview
PediMag™ & CentriMag™
Your Surgery Journey
Navigating such a big and important surgery can feel overwhelming. There are many people and resources available to help you get through your surgery journey and ultimately get you living a more comfortable and healthy life. You can also prepare by reading and learning as much as you can before heading into surgery.
Preparing for Surgery
Throughout your journey, your care team is there to support and guide you, as well as answer any questions or concerns you have.
Before your surgery, doctors called anesthesiologists will visit you. They are responsible for keeping you asleep during surgery. You will not feel any pain while you are asleep. All you will remember is traveling down to the operating room.
Your Surgery Day
The surgeon performs a sternotomy which involved opening your chest and implanting the cannulae into your heart. This will leave a scar on your chest. During the surgery, you will be on a heart and lung bypass machine, which helps circulate your blood during the operation.
After the VAD is turned on, the settings are adjusted to provide the correct blood flow to your body.
After Surgery
When you wake up from surgery, you will be in the Intensive Care Unit (ICU).
Surgery will make you feel weak and sleepy. For these reasons, you will have a plastic tube in your mouth that will help you breathe. You will also have many special IVs, cables, and drains, which are needed to monitor your VAD and heart function.
This medical equipment is necessary to monitor you and give you the medicines needed for recovery. All the equipment and lines can be startling to see, but they are completely normal. Day by day, your care team will work toward removing lines and tubes. It is also important to get you moving soon after surgery. Getting out of bed as soon as possible will help your body heal.
As with any surgery, you will probably feel some pain afterwards. Once your care team thinks you’re strong enough to be more awake and breathe on your own, your medicines keeping you sleepy will be turned off. Your breathing tube will be removed, and you will be given oxygen using a nasal cannula or mask. Your care team may also decide to give you a boost of nutrition, feeding you through a special tube in your nose called a nasogastric tube.
Recovery Self Care
When your breathing tube is out and you’re fully awake, this is when rehabilitation begins. Specially trained physical and occupational therapists will assist you in getting out of bed for the first time after surgery. Your care team will be there to support you every step of the way.
Your cannula sites will need to have dressing changes using sterile technique. Your care team will use sterile gloves and wear masks during dressing changes. How often your dressings are changed will be determined by your care team.
Recovery is a slow and steady process. Everyday you will gain more strength and your care team will help you make decisions for the next steps in your journey.
Device Components
Cannulae
During VAD surgery, your heart surgeon will place cannulae that are special tubes made of a very soft silicone material. These soft cannulae will come out of your lower chest area just below your breastbone.
Your heart has two pumping chambers, a left ventricle and a right ventricle. Your cardiologist and surgeon will decide if you need support on just one ventricle or both. If you only need support for one ventricle, you will have two cannulae. If you need support for both ventricles, you will need four cannulae.
Blood Pump
The soft cannulae connect to a blood pump that is chosen especially for you. This blood pump is hand-crafted by scientists and engineers to provide adequate blood flow to your entire body. It’s like a little heart that is outside of your body.
Your blood pump has another tube connected to it where air will move in and out of it. But don’t worry, the air will not go into your body. Instead the air helps the blood pump to fill and push blood out just like a real heart can.
IKUS
The IKUS is an air compressor that helps move air in and out of your blood pump, helping it fill and eject. Your Berlin Heart makes a humming sound, which is normal. A computer sits on top of the IKUS and allows doctors to adjust the settings of your Berlin Heart. There are several settings your care team may adjust, like the air pressure strength, how often the air pressure moves in and out, and how many times your Berlin Heart pumps.
Benefits
The Berlin Heart helps patients with heart failure, as it improves blood circulation. A Berlin Heart may help reduce heart failure symptoms and improve quality of life while waiting for a heart transplant or your heart to get better.
Risks
There are some risks with a Berlin Heart, but your care team will work hard to keep you safe.
Infection
The soft cannula will come out of your lower chest and will need to be cleaned frequently. This is important because bacteria lives on your skin and may cause an infection at your cannula site. You may feel nervous the first few times your dressings are changed, but your care team will be there to support you.
Stroke
There is a risk of stroke with all VADs. A clot can form in the VAD, become dislodged, and may travel up a blood vessel to the brain. A blood clot in the brain leads to a decreased blood flow to the brain in that specific area, and this is called a stroke. Your care team will manage your blood thinner medicines and levels carefully to try to prevent a stroke. Sometimes, even with perfect levels, a stroke will occur.
Your care team will monitor you for the following symptoms:
- Headache
- Confusion
- Numbness and/or tingling on one side of the body
- Weakness on one side of the body
- Slurred speech
Bleeding
There is a risk of bleeding with all VADs. To prevent clots from forming in the device, you have to be on a blood thinner. Sometimes the blood thinner will lead to bleeding that may require a change in medicines, a blood transfusion, or in some cases, a surgery to stop the bleeding. Your care team will manage your blood thinner medicine and levels carefully to try to prevent bleeding. Sometimes, even with perfect levels bleeding will occur.
Pediatric VAD Infections
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Take ACTION Reducing Stroke Rates
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