Background <p>Patients with left ventricular assist devices (LVAD) experience unique challenges shaped by both device characteristics and cultural context. Their psychosocial and cultural implications remain underexplored, especially in non-Western contexts. This study explored the lived experiences of LVAD implantation patients in the context of Chinese culture.</p> Methods <p>A hermeneutic phenomenological approach was employed, involving five Chinese patients who had undergone LVAD implantation. Data were collected through semi-structured interviews, audio-recorded, and transcribed verbatim. And data analysis based on the methodology of Interpretive phenomenological analysis (IPA).</p> Results <p>Two themes that emerged from the analysis: (1) Perceived loss of mastery, (2) Coping Strategies. The former includes five subthemes: contrast-induced disparity, restrictions imposed by the device, insufficient external support, loss of control over self-management, and emotional dysregulation, which represent the core adaptive challenge following implantation. The latter encompasses two subthemes: reconstruction of self-care ability and emotional adjustment.</p> Conclusion <p>This study reveals that Chinese LVAD patients experience a pervasive loss of mastery after implantation and adopt adaptive coping strategies through self-care reconstruction and emotional adjustment. Family support has a unique yet paradoxical influence on patients’ adaptation in the Chinese cultural context. Targeted interventions that combine functional and psychological support with culturally appropriate family-based strategies are essential for restoring patients’ sense of mastery and improving long-term clinical outcomes.</p> Graphical abstract <p></p>