Surgical Correction of Spontaneous Outflow Graft Twisting of HeartMate 3 LVAD via a Subcostal Approach
Outflow Graft Twisting
DOI:
https://doi.org/10.1532/hsf.4405Keywords:
Heart mate 3, subcostal approach, graft twistAbstract
We present two cases of successful surgical correction of a HeartMate 3 left ventricular assist device (LVAD) outflow graft twisting through a subcostal approach. These twistings were diagnosed with computed tomography or pull-back pressure measurement. Technically, a subcostal approach allowed us to access directly the twisted outflow graft and the device connector in a less invasive fashion as compared with a re-sternotomy. Diagnostic modality and surgical tips that address graft twisting are presented within the discussion of these two case studies. The institutional review board of our institution approved this study and waived the requirement for informed consent.
References
Mehra MR, Salerno C, Naka Y, et al. 2018. A tale of the twist in the outflow graft: An analysis from the MOMENTUM 3 trial. J Heart Lung Transplant. 37(11):1281-1284.
Mehra MR, Uriel N, Naka Y, et al. 2019. A Fully Magnetically Levitated Left Ventricular Assist Device – Final Report. N Engl J Med. 380(17):1618-1627.
Potapov EV, Netuka I, Kaufmann F, Falk V, Mehra MR. 2018. Strategy for surgical correction and mitigation of outflow graft twist with a centrifugal-flow left ventricular assist system. J Heart Lung Transplant. 37(5):670-673.
Schmitto JD, Hanke JS, Rojas SV, Avsar M, Haverich A. 2015. First implantation in man of a new magnetically levitated left ventricular assist device(HeartMate III). J Heart Lung Transplant. 34(6):858-860.
