Hybrid Exclusion of HeartMate ІІ Left Ventricular Assist Device After Bridge to Recovery

Abstract

We present a hybrid technique of left ventricular assist device exclusion after bridge to recovery in a pediatric patient, using percutaneous occlusion of the outflow graft and surgical excision of driveline. This technique has the advantage of avoiding chest reentry and cardiopulmonary bypass.

HeartMate II pump exchange with HeartMate III implantation to the descending aorta

“…Although implanting a HeartMate III device via a left lateral thoracotomy technique has been described, our case is unique since we did not extract the HeartMate II device. Removal of the HeartMate II device would require a longer time on bypass and the need for a redo‐sternotomy …”

“…Removal of the HeartMate II device would require a longer time on bypass and the need for a redosternotomy. 6 Implantation of the LVAD via a lateral thoracotomy approach may be sub-optimal in transplant candidates because it is hard to reach the anastomosis to the descending aorta during transplantation. 1 If the pump is not infected, we believe that the graft can be transected, oversewn, and left in place, which significantly simplifies the operation.…”