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J Thorac Cardiovasc Surg 2008;135:453-454
© 2008 The American Association for Thoracic Surgery

Brief Communication

Limited surgical approach for explanting the HeartMate II left ventricular assist device after myocardial recovery

S. Haj-Yahia, MD, E.J. Birks, MD, G. Dreyfus, MD, A. Khaghani, FRCS*

Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield Hospital, National Heart and Lung Institute, Imperial College for Science, Technology and Medicine, London, United Kingdom

Received for publication August 17, 2007; revisions received October 5, 2007; accepted for publication October 15, 2007.

* Address for reprints: Asghar Khaghani, FRCS, Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield Hospital NHS Trust, Hill End Rd, Harefield, Middlesex, London UB9 6JH, United Kingdom. (Email: S.Haj-Yahia@imperial.ac.uk).

The first 20% of the full text of this article appears below.

Successful myocardial recovery in patients with end-stage heart failure after left ventricular assist device (LVAD) support combined with pharmacologic therapy is frequently encountered in our institution.1Go Minor surgical trauma in explanting ventricular assist devices (VADs) from recovered patients plays an important role in a successful bridge-to-recovery procedure.2,3Go We report a minimally invasive technique for explanting the HeartMate II LVAD (ThermoCardiosystems, Inc, Woburn, Mass).

Clinical Summary

The technique consists of a small (approximately 5 cm) left anterolateral thoracotomy through the fifth intercostal space, followed by a small right anterior parasternal thoracotomy (approximately 4 cm) through the second intercostal space and a small superior epigastric incision (approximately 5 cm) dissecting and exposing the apex, the outflow joints, and the body of the device, respectively (Go Figure 1). Cardiopulmonary bypass (CPB) is established through arterial cannulation in the LVAD outflow line and femoral vein cannulation for venous return . . . [Full Text of this Article]






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