title: Technique for less invasive implantation of Heartmate II left ventricular assist device without median sternotomy.
abstract: The standard implantation of the Heartmate II left ventricular assist device (LVAD) (Thoratec Inc, Pleasanton, CA) involves a median sternotomy. There are some theoretical advantages to avoiding a median sternotomy in LVAD implantation. Hill et al(1) introduced the concept of implantation of LVADs via a combination of right mini-thoracotomy and left subcostal incision and used this approach to implant the Thoratec paracorporeal LVAD (Thoratec Inc). Gregoric et al(2) subsequently described a less invasive approach for implanting the Heartmate II LVAD without median sternotomy by using a subcostal incision and a right mini-thoracotomy, and they used the approach in 3 patients. With some modifications, we now use this method for routine implantation of the Heartmate II and describe our technique.
authors.affiliation: Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, New York, USA. anelechi.anyanwu@mountsinai.org
authors.forename: Anelechi C
authors.initials: AC
authors.lastname: Anyanwu
mesh_terms: D002315:Cardiopulmonary Bypass; D002404:Catheterization; D006352:Heart Ventricles / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D013908:Thoracotomy / Q000295:instrumentation / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000601:surgery* / Q000628:therapy