Skip to main content

Left Ventricular Assist Devices: Management and Surgical Techniques

  • Chapter
  • First Online:
Mechanical Support for Heart Failure

Abstract

Successful implantation of a left ventricular assist device requires preoperative preparation, effective implantation, and vigilant postoperative care. Optimizing end organ function, clearance of infection, normalization of pulmonary pressures, and achieving euvolemia prior to surgery are key. Surgical implantation can be done through a variety of techniques including full sternotomy, partial sternotomy, and thoracotomy as well as with or without cardiopulmonary bypass support. Postoperative management of right ventricular function, pump speed, fluid shifts, and bleeding are key to good perioperative outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sun BC, et al. Placement of long-term implantable ventricular assist devices without the use of cardiopulmonary bypass. J Heart Lung Transplant. 2008;27(7):718–21.

    Article  Google Scholar 

  2. Awad H, Sun BC, et al. Initial experience with off-pump left ventricular assist device implantation in single center: retrospective analysis. J Card Surg. 2010;5(1):123.

    Google Scholar 

  3. Feldman D, et al. The 2013 International Society for Heart and Lung Transplantation guidelines for mechanical circulatory support: executive summary. J Heart Lung Transplant. 2013;32:157–87.

    Article  Google Scholar 

  4. Morgan JA, et al. The 2013 International Society for Heart and Lung Transplantation guidelines for mechanical circulatory support: intraoperative and immediate postoperative management. J Heart Lung Transplant. 2013;32:1–21.

    Article  Google Scholar 

  5. Danter MR, et al. A prospective, controlled, un-blinded, multi-center clinical trial to evaluate the thoracotomy implant technique of the HVAD system in patients with advanced heart failure: results of the LATERAL trial. J Heart Lung Transplant. 2017;36(4).

    Google Scholar 

  6. Popov, et al. HeartWare left ventricular assist device implantation through bilateral anterior thoracotomy. Ann Thorac Surg. 2012;93:674–6.

    Article  Google Scholar 

  7. Schmitto JD, et al. Implantation of a centrifugal pump as a left ventricular assist device through a novel, minimized approach: upper hemisternotomy combined with anterolateral thoracotomy. J Thorac Cardiovasc Surg. 2012;143(2):511–3.

    Article  Google Scholar 

  8. Sileshi B, et al. In-hospital outcomes of a minimally invasive off-pump left thoracotomy approach using a centrifugal continuous-flow left ventricular assist device. J Heart Lung Transplant. 2015;34(1):107–12.

    Article  Google Scholar 

  9. Pierson RN, et al. Left ventricular assist device implantation via left thoracotomy: alternative to repeat Sternotomy. Ann Thorac Surg. 2002;73(3):997–9.

    Article  Google Scholar 

  10. Cheung A, et al. Minimally invasive, off-pump explant of a continuous-flow left ventricular assist device. J Heart Lung Transplant. 2010;29(7):808–10.

    Article  Google Scholar 

  11. Cheung A, et al. Off-pump implantation of the HeartWare HVAD left ventricular assist device through minimally invasive incisions. Ann Thorac Surg. 2011;91(4):1294–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert J. Steffen MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Steffen, R.J., Sun, B.C. (2020). Left Ventricular Assist Devices: Management and Surgical Techniques. In: Karimov, J., Fukamachi, K., Starling, R. (eds) Mechanical Support for Heart Failure . Springer, Cham. https://doi.org/10.1007/978-3-030-47809-4_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-47809-4_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47808-7

  • Online ISBN: 978-3-030-47809-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics