title: Minimally invasive thoratec Heartmate II implantation in the setting of severe thoracic aortic calcification.
abstract: A minimally invasive approach for implantation of the Heart Mate II left ventricular assist device (LVAD) in the setting of severe thoracic aortic calcification is described. Cannulation of the left ventricular apex is performed through a left subcostal incision with preperitoneal creation of the pump pocket. To avoid outflow graft anastomosis to a severely calcified ascending or descending aorta, the outflow graft is tunneled through the diaphragm, the right thoracic cavity, and the second intercostal space, and is anastomosed to the right subclavian artery. This technique is especially appealing in patients with generalized aortic calcification undergoing LVAD implantation.
authors.affiliation: Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Riebandt
authors.forename: Sigrid
authors.initials: S
authors.lastname: Sandner
authors.forename: Stephane
authors.initials: S
authors.lastname: Mahr
authors.forename: Thomas
authors.initials: T
authors.lastname: Haberl
authors.forename: Angela
authors.initials: A
authors.lastname: Rajek
authors.forename: Guenther
authors.initials: G
authors.lastname: Laufer
authors.forename: Heinrich
authors.initials: H
authors.lastname: Schima
authors.forename: Daniel
authors.initials: D
authors.lastname: Zimpfer
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D056888:Patient Positioning; D019919:Prosthesis Implantation / Q000379:methods; D012720:Severity of Illness Index; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery; D013908:Thoracotomy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: 27