Patients can be recovered in the standard postoperative anesthesia care unit unless intensive care is required. After arriving in the postanesthesia care unit (PACU), ensure that an ICD is reprogrammed to active therapy. Patients should be extubated when they meet criteria; however, extra care should be taken during tracheal extubation to minimize hypertension and tachycardia that can decrease LVAD output.

Adequate analgesia is important with appropriate caution to prevent hypoxia, hypercarbia, and acidosis, which can increase RV afterload and potentiate RV failure.

Reinstitution of full anticoagulation occurs when the risk of postoperative bleeding is low. Patients are usually bridged to heparin with a partial thromboplastin time (PTT) of 60 to 80 seconds until the international normalized ratio (INR) reaches a target range of 2.0 to 3.0. Postoperative bleeding is a common complication and should be monitored carefully, especially during the reinstitution of anticoagulation.