Abstract
Ventricular assist device implantation is routinely performed with cardiopulmonary bypass. Several points support the routine use of cardiopulmonary bypass. These include hemodynamic stabilization during the procedure and the ability to perform a visual inspection of the left ventricular cavity together with resection of trabecular obstacles as well as removal of left ventricular thrombi at the time of assist device implantation. However, cardiopulmonary bypass causes a cascade of adverse events, and avoiding cardiopulmonary bypass or replacing it by ECMO has been shown to be beneficial in high-risk coronary cases as well as lung transplantation. Based on these and other assumptions, several programs have started to replace cardiopulmonary bypass by ECMO or off-pump techniques for ventricular assist device implantation. We review surgical technique as well as current evidence for these alternative implant strategies, which ultimately aim at reducing the overall trauma of ventricular assist device implantation.
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Zimpfer, D. (2017). To Pump or Not to Pump: The Role of CPB or ECMO. In: Montalto, A., Loforte, A., Musumeci, F., Krabatsch, T., Slaughter, M. (eds) Mechanical Circulatory Support in End-Stage Heart Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-43383-7_25
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DOI: https://doi.org/10.1007/978-3-319-43383-7_25
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