title: Concomitant minimally invasive HVAD and transapical aortic valve implantation.
abstract: Minimally invasive left ventricular assist device (LVAD) implantation with the HeartWare VAD (HVAD) has been reported lately as an alternative approach to median sternotomy due to its favorable results regarding sternal wound complications, mediastinitis, postoperative bleeding, and right ventricular failure (RVF). Relevant aortic regurgitation is a cardiac comorbidity that requires surgical repair at the time of LVAD implantation to reduce recirculation and ensure adequate forward flow. We herein report on a patient with severely reduced left ventricular function due to ischemic cardiomyopathy, moderate aortic regurgitation, and a reduced right ventricular function. We performed minimally invasive HVAD implantation with concomitant transapical transcatheter aortic valve replacement. We believe this hybrid procedure could potentially reduce the risk for post-LVAD RVF because it preserves the pericardial geometry and obviates the need for cardioplegic arrest.
authors.affiliation: From the Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schaefer
authors.forename: Hendrik
authors.initials: H
authors.lastname: Treede
authors.forename: Alexander
authors.initials: A
authors.lastname: Bernhardt
authors.forename: Florian M
authors.initials: FM
authors.lastname: Wagner
authors.forename: Hermann
authors.initials: H
authors.lastname: Reichenspurner
authors.forename: Tobias
authors.initials: T
authors.lastname: Deuse
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*