Intermediate and long-term VAD implantation is often scheduled as open-heart surgery. Short-term VAD implantation frequently takes place during the course of another surgery in which the patient cannot be weaned from the heart-lung machine.

If the VAD implantation is a scheduled procedure, patients should prepare in advance for a hospital stay of at least a week. The patient is usually admitted on, or a day before, the scheduled date for surgery. In the hospital, the patient will undergo a battery of tests. Even if these tests were already done days or weeks before surgery, they will be done again just before surgery to be sure that the patient’s medical condition has not changed. They include:

Eight to twelve hours before surgery, all patients are placed on NPO (non per os; nothing by mouth) status. This means they are not permitted to eat, drink or take anything by mouth until after their surgery. Smokers will have been instructed to completely avoid smoking for at least two weeks before their surgery to prevent problems in blood flow, clotting or breathing. Certain medications may need to be reduced or stopped temporarily, so patients should discuss their medication schedules with their cardiologist before surgery. Patients will receive detailed information about necessary preparation, what will happen during surgery and what to expect during recovery from their physicians.

Immediately before surgery, the patient will be given specific pre-operative medications and then “prepped” for surgery. First, the chest area is shaved. Next, the surgical team creates a sterile environment by swabbing the patient’s chest with an antiseptic solution and covering the area with sterile surgical drapes. An intravenous (IV) line will also be started, usually in the forearm or back of the hand.

The patient is then given a sleep-inducing medication through the IV line. Once asleep, the patient will continually breathe a mixture of oxygen and anesthetic gas (general anesthesia) to make sure that he or she remains asleep throughout the entire surgery.