LVAD Driveline Management

You can still move freely and do many routine activities if you have an LVAD. But you’ll need to take some precautions to protect the driveline that exits your body and connects your LVAD to your controller. Depending on which device you have, you may need to wear a stabilization belt or band around your abdomen to keep the driveline from moving around too much.

• Be careful not to twist, kink or pull on the driveline.
• Be sure that your controller is secure, so there’s no risk of it falling and pulling on your driveline.
• Make sure the driveline doesn’t get pulled or snagged.
• If you’re keeping your controller inside a zippered bag, make sure the driveline doesn’t get caught in the zipper.
• Carefully wipe any dirt or grime off the driveline with a damp cloth.
• Avoid getting the driveline wet, especially right at the exit site.
• Be careful around pets and children so they don’t accidently damage the driveline or other equipment.

Caring for the Driveline Exit Site

It’s extremely important to keep your driveline exit site clean and free of infection. While you’re in the hospital, the LVAD team will teach you and/or your caregiver how to change the driveline exit site dressing. Depending on your hospital’s policy, you may need to change the dressing every day, or two or three times a week.

Many patients and caregivers feel anxious at first about changing the dressing. Remember that your LVAD team will give you thorough training before you leave the hospital. Visit the Community Forums to see what other LVAD patients and caregivers have to say about dressing changes.

Guidelines for Dressing Changes

Every hospital or clinic has its own specific directions and recommendations for exit site care, which you should follow. But these are some general guidelines:

• Always wash your hands before starting the dressing change.
• Never put ointments, powders or lotions on or around the exit site unless you’re instructed to do so.
• Follow your LVAD team’s directions on how often to change the dressing.
• Follow strict “sterile technique” every time you change the dressing or touch the exit site area. (See below for more on sterile technique)
• Let your LVAD team know right away if there is any redness, swelling or drainage around the exit site, or if you’re experiencing pain or a fever. All of these are signs of possible infection.

Sterile Technique

To prevent infection, you or your caregiver will need to use sterile technique when changing your driveline dressings. (“Sterile” means free from germs.) The general rules of sterile technique are:

• Always wash your hands before and after the procedure:
  • Remove all rings and jewelry from your hands and wrists
  • Wet your hands and wrists
  • Apply soap and vigorously rub your hands together for 15 seconds or more. Wash around the backs of both hands as well as between your fingers, around cuticles and under fingernails.
  • Rinse your hands thoroughly
  • Dry your hands thoroughly with paper towel
• Keep your sterile supplies dry. Remember: if the outer wrapper of the supplies is not sealed, it’s not sterile.
• Prepare a work area by washing a counter or table with a disinfectant spray. Make sure the surface is dry before you begin.
• Take special care when you handle your supplies to keep them sterile. Do not touch the sterile supplies inside the wrapper without wearing sterile gloves.
• Wear a hat and mask if you’ve been instructed by your hospital to do so.
• Try not to reach over the sterile supplies while changing the dressings. It’s usually best to have your work surface off to the side.

For more detailed instructions and visuals on sterile technique, click here.