Left subclavian artery as an alternative site for left ventricular assist device outflow graft in challenging situations

Abstract

Left ventricular assist device (LVAD) has emerged as an effective surgical therapy for end-stage heart failure. 1,2 The standard operative approach consists of a full median sternotomy, and during cardiopulmonary bypass, the LVAD is implanted by inserting the inflow cannula inside the left ventricle apex (LVA) and anastomosing the outflow graft to the ascending aorta. In an effort to preserve the sternum or avoid difficult re-entries after previous