scholarly journals Complications of Minimally Invasive Left Ventricular Assistance Device Implantation

2021 ◽  
Author(s):  
Mleyhi Sobhi ◽  
Miri Rim ◽  
Denguir Raouf
Keyword(s):  
Minimally Invasive ◽  
Heart Transplantation ◽  
Median Sternotomy ◽  
Left Ventricular ◽  
Implantation Technique ◽  
Ventricular Assist ◽  
Left Ventricular Assistance Device ◽  
Ventricular Assistance Device ◽  
Ventricular Assistance ◽  
Left Ventricular Assistance

Indication of Ventricular assistance is advanced cardiac failure with maximal medical and surgical treatment has been used. The ventricular assistance has two main purposes: first, to maintain circulation by discharging the ventricle (s) untill to recovery, or to ensure patient survival by replacing cardiac function permanently or transitionally for patients waiting for heart Transplantation. The encouraging results of the partial or total artificial heart and the miniaturization of these devices allow their use in permanent implantation for patients with heart failure that is not eligible for heart transplantation. In left mono-ventricular assistance, blood is taken from the apex of the left ventricle (LV) and reinjected in the ascending aorta. The classic surgical approach is a total median sternotomy. Other minimally invasive approaches for the implantation or explanation of left ventricular assist devices have been published and have shown encouraging results. These alternatives currently play an important role in certain indications and in patients with heavy medical history. Nevertheless, the complications of the ventricular assistance even by minimally invasive approaches might be serious and represent a turning point in the life of the patients. In this chapter, we describe the implantation technique of left ventricular assistance device (LVAD) and we discuss its advantages and disadvantages including possible complications.

Analysis of Minimally Invasive Left Thoracotomy HVAD Implantation – A Single-Center Experience

2018 ◽  
Vol 67 (03) ◽  
pp. 170-175 ◽  
Author(s):  
D. Reichart ◽  
C.F. Brand ◽  
A.M. Bernhardt ◽  
S. Schmidt ◽  
A. Schaefer ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ventricular Assist Device ◽  
Median Sternotomy ◽  
Left Ventricular ◽  
Implantation Technique ◽  
Assist Device ◽  
Ventricular Assist ◽  
Invasive Approach ◽  
Left Thoracotomy ◽  
Bridge To Transplant

Background Minimally invasive left ventricular assist device (LVAD) implantation may reduce peri-/postoperative complications and risks associated with resternotomies. In this study, we describe our first results using a minimally invasive LVAD implantation technique (lateral thoracotomy [LT] group). These results were compared with LVAD implantations done via full median sternotomy (STX group). Methods HVAD (HeartWare, Framingham, Massachusetts, United States) implantations in 70 patients (LT group n = 22, 52 ± 15 years old; STX group n = 48, 59 ± 11 years old) were retrospectively analyzed. Minimally invasive access via left thoracotomy was feasible in 22 patients. Peri- and postoperative analyses of survival and adverse events were performed. Results No survival differences were observed between the LT and STX group (p = 0.43). LT patients without temporary right ventricular assist device (tRVAD) showed a significantly better survival rate compared to LT patients with concomitant tRVAD implantation (p = 0.02), which could not be demonstrated in the STX group (p = 0.11). Two LT and four STX patients were successfully bridged to heart transplantation and three STX patients were successfully weaned with subsequent LVAD explantations. LVAD-related infections (n = 4 LT group vs n = 20 STX group, p = 0.04) were less likely in the LT group. No wound dehiscence occurred in the LT group, whereas five were observed in the STX group (p = 0.17). The amount of perioperative blood transfusions (within the first 7 postoperative days) did not differ in both study groups (p = 0.48). Conclusion The minimally invasive approach is a viable alternative with the possibility to reduce complications and should be particularly considered for bridge-to-transplant patients.

Postcardiotomy left ventricular assistance device implantation in a child: brief considerations

2012 ◽  
Vol 3 (1) ◽  
pp. 11826578
Author(s):  
Antonio di Coste ◽  
Daniela Codazzi ◽  
Maria Antonietta Scalera ◽  
Carlo Mancini ◽  
Dario Troise ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Device Implantation ◽  
Left Ventricular Assistance Device ◽  
Ventricular Assistance Device ◽  
Ventricular Assistance ◽  
Left Ventricular Assistance

scholarly journals Numerical study of shear-based hemolysis in aorta with left ventricular assistance device

2021 ◽  
Vol 321 ◽  
pp. 03009
Author(s):  
Jianfei Song ◽  
Louis Marcel ◽  
Mathieu Specklin ◽  
Smaine Kouidri
Keyword(s):  
Heart Failure ◽  
Numerical Study ◽  
Severe Heart Failure ◽  
Left Ventricular ◽  
Flow Topology ◽  
Left Ventricular Assistance Device ◽  
Ventricular Assistance Device ◽  
Ventricular Assistance ◽  
Left Ventricular Assistance

Ventricular assistance devices (VADs) for heart failure treatment have been paid high attention among researchers for decades. However, the follow-up complications such as hemolysis and thrombosis require further optimization for this technique. Shear stress has been demonstrated to be significantly related to the hemolysis because of the rupture of red blood cells membrane with a leaking of hemoglobin in the plasma. This issue has already been investigated inside the pump of VAD, but estimations are still lacking regarding hemolysis generation in the aorta itself after VAD implantaion. Thus, the present study aims to evaluate the hemolysis in aorta through establishing the 3D numerical model of aorta with left ventricular assistance device (LVAD). Non-Newtonian Carreau model has been adopted. Comparisons of hemolysis evaluation have been made with two different mathematical models existing in literature. Moreover, the flow topology and hemodynamic variations have been studied. Different working conditions of LVAD have been considered corresponding to different heart failure severities. The results reveal a relatively low level of hemolysis risks in aorta. The thrombosis is more prone to occur in the case of severe heart failure condition.

Caregiving for patients requiring left ventricular assistance device support

Heart & Lung ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 196-200 ◽  
Author(s):  
Kathy Baker ◽  
Maureen Flattery ◽  
Jeanne Salyer ◽  
Kathryn H. Haugh ◽  
Megan Maltby
Keyword(s):  
Left Ventricular ◽  
Left Ventricular Assistance Device ◽  
Ventricular Assistance Device ◽  
Ventricular Assistance ◽  
Left Ventricular Assistance
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