title: Rectus-Sparing Technique for Driveline Insertion of Ventricular Assist Device.
abstract: We present a new technique for driveline insertion of the HeartWare ventricular assist device (HVAD) designed to preserve the integrity of the abdominal wall structure. Because of the size of the HVAD driveline connector (12 mm in diameter: triple the size of the driveline cable), the standard tunneling maneuver can result in tearing of the abdominal wall muscle layer, which is a primary mechanism to prevent ascending driveline infection. We find that our technique is particularly useful in children because their abdominal wall muscles are more fragile and thereby prone to accidental injury with blunt penetration when the standard technique is used.
authors.affiliation: Department of Cardiology, Texas Children's Hospital-Baylor College of Medicine, Houston, Texas.
authors.forename: S Yukiko
authors.initials: SY
authors.lastname: Asaki
authors.affiliation: Department of Surgery, Congenital Heart Surgery, Texas Children's Hospital-Baylor College of Medicine, Houston, Texas.
authors.forename: E
authors.initials: E
authors.lastname: Dean McKenzie
authors.affiliation: Department of Surgery, Congenital Heart Surgery, Texas Children's Hospital-Baylor College of Medicine, Houston, Texas.
authors.forename: Barbara
authors.initials: B
authors.lastname: Elias
authors.affiliation: Department of Surgery, Congenital Heart Surgery, Texas Children's Hospital-Baylor College of Medicine, Houston, Texas. Electronic address: ixadachi@texaschildrens.org.
authors.forename: Iki
authors.initials: I
authors.lastname: Adachi
mesh_terms: D000009:Abdominal Muscles / Q000293:injuries; D006353:Heart-Assist Devices; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000517:prevention & control; D017568:Rectus Abdominis / Q000601:surgery*