title: Minimally invasive removal of a temporary RVAD.
abstract: We describe a minimally invasive technique for the removal of a temporary right ventricular assist device (RVAD) that provided support concomitant with durable left ventricular assist device support. The RVAD cannulas are mobilized through a small subxiphoid incision at the cannula exit site. Both cannulas are transected subcutaneously, then occluded with plugs made of rolled bovine pericardium, and the skin is closed. The cannula remnants are left in place until heart transplantation is accomplished. To minimize risk of thrombus formation at the cannula tips and subsequent embolization into the right atrium or pulmonary artery, anticoagulation is increased to achieve an international normalized ratio (INR) in the range of 2.5-3.0.
authors.affiliation: From the *Institute for Clinical and Experimental Medicine, Prague, Czech Republic. †Second Department of Surgery, Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Netuka
authors.forename: Peter
authors.initials: P
authors.lastname: Ivák
authors.forename: Ondrej
authors.initials: O
authors.lastname: Szarszoi
authors.forename: Marian
authors.initials: M
authors.lastname: Urban
authors.forename: Jiří
authors.initials: J
authors.lastname: Novotný
authors.forename: Josef
authors.initials: J
authors.lastname: Bešík
authors.forename: Jiri
authors.initials: J
authors.lastname: Malý
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D057785:Catheters; D002417:Cattle; D020878:Device Removal / Q000379:methods*; D006333:Heart Failure / Q000601:surgery; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010496:Pericardium; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials