How to do it
Use of the Novel Surgical Enhancement Tools for Less Invasive Abbott HeartMate 3 Implantation

https://doi.org/10.1016/j.athoracsur.2018.04.024Get rights and content

This report presents an initial experience with the novel Abbott surgical enhancement tools for less invasive HeartMate 3 (Abbott, Chicago, IL) left ventricular assist system implantation. Three new devices are introduced: (1) a mini–apical cuff with (2) a cuff holder and (3) a newly designed coring knife, facilitating access through a left sided minithoracotomy.

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Technique

Less invasive HeartMate 3 implantation was performed in a 66-year-old male patient with end-stage cardiomyopathy in Intermacs Level 4. The patient also had relevant aortic regurgitation, which was also addressed during LVAD implantation.

For LVAD implantation, the patient was placed in a supine position, and standard endotracheal intubation was performed. In addition, a Swan-Ganz catheter was placed, and a transesophageal echocardiography (TEE) probe was inserted. TEE is important in less

Comment

Less invasive implantation of the Medtronic HVAD (Medtronic, Minneapolis, MN) through a left-sided thoracotomy and an upper hemisternotomy or right-sided thoracotomy has evolved as a generally accepted alternative to the standard sternotomy approach. Several centers including our group have adopted the same technique for HeartMate 3 implantation. However, the initial surgical tools and especially the rather bulky apical cuff necessitated significantly larger thoracotomies, and apical cuff

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