title: Implantable ventricular assist device exchange with focused intravascular deairing techniques.
abstract: As ventricular assist devices are increasingly adopted and widely implemented as a highly effective therapy for end-stage heart disease, extended utilization periods for destination therapy or bridge-to-transplantation have created the possibility of device failure, infection, or thrombosis, requiring challenging implant exchanges. A major problem in these operations is the risk of air embolization, particularly in a nonsternotomy approach that precludes access to the outflow aortic graft and to the ascending aorta. We report a minimally invasive, nonsternotomy HeartMate II implantable left ventricular assist device (LVAD) exchange, using peripheral cardiopulmonary support and a novel approach to continuous intravascular ascending aortic air removal.
authors.affiliation: Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. wooy@uphs.upenn.edu
authors.forename: Y Joseph
authors.initials: YJ
authors.lastname: Woo
authors.forename: Michael A
authors.initials: MA
authors.lastname: Acker
mesh_terms: D000328:Adult; D020878:Device Removal; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D012086:Reoperation