title: Less invasive implantation of HeartWare left ventricular assist device.
abstract: Mechanical support by means of ventricular assist devices is at present the most promising alternative of efforts aimed at increasing the supply of donor organs. The support of the left dysfunctional ventricle enables appropriate haemodynamic stabilization and recovery of secondary organ failure, often present in these severely ill patients. The current results of left ventricular assist device (LVAD) therapy for bridge to transplantation are excellent when compared with the outcome without the availability of this therapy. Additionally, a rapid extubation of these patients has demonstrated to be efficient in cardiac surgery for faster recovery and rehabilitation. Consequently, in recent years, surgical objectives have become much more clearly defined, and the concept of less invasive cardiac surgery can be applied to make this operation less complicated, anatomically focused with a greater clinical impact. We describe an LVAD implantation technique, applying the concept of less invasive cardiac surgery, consisting in the association of reduced surgical approaches, off-pump implantation and reduced administration of heparin dose, in order to achieve rapid extubation and rehabilitation of the patient, preserving low morbidity, and still meeting all the goals of the standard procedure.
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, University of Padova Medical School, Padova, Italy tbottio@gmail.com.
authors.forename: Tomaso
authors.initials: T
authors.lastname: Bottio
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Jonida
authors.initials: J
authors.lastname: Bejko
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gallo
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Bortolussi
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, University of Padova Medical School, Padova, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000175:diagnosis; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016027:Heart Transplantation / Q000379:methods*; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011300:Preoperative Care / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods*; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods; D020379:Risk Adjustment; D012720:Severity of Illness Index; D013908:Thoracotomy / Q000379:methods; D013995:Time; D016896:Treatment Outcome
keywords: HeartWare; Less invasive surgical technique