HeartMate 3 implantation via left antero-lateral thoracotomy to avoid resternotomy in high risk patients.

Details

Serval ID
serval:BIB_97C14BFF27AC
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
HeartMate 3 implantation via left antero-lateral thoracotomy to avoid resternotomy in high risk patients.
Journal
Multimedia manual of cardiothoracic surgery
Author(s)
Pfister R., Tozzi P., Hullin R., Yerly P., Jahns F.P., Prêtre R., Kirsch M.
ISSN
1813-9175 (Electronic)
ISSN-L
1813-9175
Publication state
Published
Issued date
25/04/2018
Peer-reviewed
Oui
Volume
2018
Language
english
Notes
Publication types: Case Reports ; Video-Audio Media
Publication Status: epublish
Abstract
Left ventricular assist devices (LVADs) are currently the best alternative to cardiac transplantation for patients with end-stage heart failure (HF) as a bridge to transplant or to decision, or as destination therapy. Full median sternotomy or minimally invasive techniques are the more standard approaches used at present.  LVADs are usually implanted between the left ventricle apex and the ascending aorta. An implantation through a left thoracotomy with an outflow graft connected to the descending aorta is much less performed nowadays due to the longer times to extubation, higher incidence of postoperative pain, and poorer hemodynamics in the ascending aorta, which may lead to thrombosis. However, some patients present a prohibitive risk for a medial approach. Also, many patients with a VAD will require future transplantation, and avoiding a sternotomy or crossing the mediastinum with the outflow graft can reduce the risks of the subsequent procedure in these patients. Various options for implantation may be used. Our described approach consists of implanting the left VAD (LVAD) via a left lateral thoracotomy and anastomosing the outflow graft to the descending aorta.
Keywords
Aged, Female, Heart Failure/physiopathology, Heart Failure/surgery, Heart Ventricles/surgery, Heart-Assist Devices, Hemodynamics, Humans, Male, Middle Aged, Prosthesis Implantation/methods, Reoperation, Sternotomy, Thoracotomy/methods
Pubmed
Create date
06/10/2018 6:49
Last modification date
20/08/2019 14:59
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