title: Minimal-access left ventricular assist device explantation.
abstract: Patients on left ventricular assist device (LVAD) support can be successfully bridged to recovery. A novel explantation technique is reviewed. Six HeartMate II patients were successfully explanted off-pump through a combination of a left anterior minithoracotomy and a subxiphoid incision. A retrospective review of the institutional LVAD database was performed. The median LVAD support duration was 191 days (range, 69-307 days). There was no procedural or 30-day mortality associated with the LVAD explantation, and all patients are in New York Heart Association I to II at a median follow-up of 688 days (range, 127-1033 days). This procedure was associated with minimal blood transfusion and short intensive care unit stay (median, 1 day; range, 1-5 days) and hospitalization (median, 4.5 days; range, 3-19 days). One postexplant embolic cerebral infarct occurred. The HeartMate II LVAD can be safely explanted through a less conventional minimal-access approach.
authors.affiliation: Division of Cardiac Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, BC Canada. acheung@providencehealth.bc.ca
authors.forename: Anson
authors.initials: A
authors.lastname: Cheung
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Soon
mesh_terms: D000328:Adult; D020878:Device Removal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome