Proper VAD maintenance is essential to both patient safety and preservation of an effective line for the administration of needed IV therapies.Using saline flushing and heparin locks is one of the most important strategies for maintaining catheter patency and preventing thrombus formation. Traditionally, heparin is the agent of choice for a lock solution. However, there are times when heparin is contraindicated. In addition, heparin has been associated with an increased risk of developing thrombocytopenia. This article reviews some home infusion practices that have evolved as means of maintaining vascular access while minimizing the use of heparin.