Author/Editor | Gregorič, Igor D; La Francesca, S; Myers, T; Cohn, W; Loyalka, P; Kar, B; Gemmato, C; Frazier, OH | |
Title | A less invasive approach to axial flow pump insertion | |
Type | članek | |
Source | J Heart Lung Transplant | |
Vol. and No. | Letnik 27, št. 4 | |
Publication year | 2008 | |
Volume | str. 423-6 | |
Language | eng | |
Abstract | Background: Implantation of a HeartMate II or a Jarvik 2000 FlowMaker left ventricular assist system (LVAS) usually involves a mid-line sternotomy and the use of cardiopulmonary bypass (CPB). In patients with numerous co-morbid conditions, however, surgical trauma may be minimized by implanting the LVAS via a minimally invasive approach, preferably without CPB. Methods: In 6 patients with end-stage heart failure and other serious co-morbidities, we implanted a HeartMate II (n = 3) or a Jarvik 2000 FlowMaker (n = 3) LVAS via a right mini-thoracotomy and a left sub-costal incision. Patients included 3 men and 3 women with a mean age of 41 years. In 3 cases, the LVAS was implanted without CPB. Results: After a mean follow-up period of 6 months, 5 patients are alive and well and on the transplant waiting list. Seven months after LVAS implantation, the remaining patient developed a hemorrhagic stroke necessitating Jarvik 2000 replacement with a new pump of the same type. Conclusions: In this small series, the combined sub-costal and mini-thoracotomy incision proved safe and technically feasible. It may be useful for other LVAS candidates who have serious co-morbidities that preclude traditional implant operations. | |
Descriptors | HEART-ASSIST DEVICES HEART VENTRICLE COMORBIDITY PREOPERATIVE CARE |