Implantation technique for the DuraHeart left ventricular assist system.
The DuraHeart is a centrifugal pump with a magnetically levitated impeller. We implant the DuraHeart blood pump, which is 72 mm in external diameter and 45 mm in height, in a preperitoneal pocket in the left upper abdomen. An apical cuff is sutured to the apical hole in the left ventricular apex with 12 mattress sutures of 3-0 Prolene pledgeted with Dacron felt. In the first six mattress sutures, the needle is exited from the apical hole after a full-thickness bite of myocardium, and in six additional mattress sutures, the needle is exited from the epicardial edge of the apical hole. Next, a double purse-string suture with 3-0 Prolene is placed on the Dacron pledgets around the apical hole. After the inflow conduit has been connected to the inlet port of the blood pump, the inflow conduit is secured to the apical cuff. The graft portion of the outflow conduit, which was connected to the blood pump beforehand, is sewn end-to-side to the ascending aorta with a 4-0 Prolene suture. Gentle suture connection of the apical cuff to the left ventricular apex and optimal alignment of the inflow conduit, which is bent by 60 degrees, are crucial in the surgical procedure. A detailed description of the implantation technique is presented to facilitate the use of this system.
Komoda
Takeshi
T
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. komoda@dhzb.de
Weng
Yuguo
Y
Nojiri
Chisato
C
Hetzer
Roland
R
D006348:Cardiac Surgical Procedures / Q000379:methods*; D006353:Heart-Assist Devices; D006801:Humans; D019919:Prosthesis Implantation / Q000379:methods*; D013536:Suture Techniques