title: Left thoracotomy HeartWare implantation with outflow graft anastomosis to the descending aorta: a simplified bridge for patients with multiple previous sternotomies.
abstract: Advances in mechanical circulatory support have been critical in bridging patients awaiting heart transplantation. In addition, improvement in device durability has enabled left ventricular assist device therapy to be applied as destination therapy in those not felt to be transplant candidate. Because of the increasing complexity of patients, there continues to be a need for alternative strategies for device implantation to bridge high-risk patients awaiting heart transplantation, wherein the risks of numerous previous sternotomies may be prohibitive. We present a unique technique for placement of the HeartWare ventricular assist device via left anterior thoracotomy to the descending aorta in a patient awaiting heart transplantation with a history of multiple previous sternotomies.
authors.affiliation: From the *Division of Cardiovascular Surgery, Vanderbilt University Medical Center, Nashville, TN; †Department of Cardiology, Vanderbilt University Medical Center, Nashville, TN; and ‡Division of Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Ramanan
authors.initials: R
authors.lastname: Umakanthan
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Haglund
authors.forename: John M
authors.initials: JM
authors.lastname: Stulak
authors.forename: Lyle D
authors.initials: LD
authors.lastname: Joyce
authors.forename: Rashid
authors.initials: R
authors.lastname: Ahmad
authors.forename: Mary E
authors.initials: ME
authors.lastname: Keebler
authors.forename: Simon
authors.initials: S
authors.lastname: Maltais
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D001163:Arteriovenous Anastomosis; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D012086:Reoperation; D013908:Thoracotomy / Q000379:methods*