Abstract
Purpose A certain percentage of the left ventricular assist device (LVAD) patients inevitably require a device exchange. While it is clinically an important entity, only a handful of studies have been reported. Methods and Materials From Dec 2008 to Oct 2012, a total of 28 device exchanges (HeartMate II to HeartMate II) were performed. Since June 2011, we have employed the subcostal approach for device exchange if indicated. A full sternotomy was used in 13 cases (F group) and a subcostal approach was in 15 cases (S group). Preoperative and postoperative data were retrospectively reviewed. Results There was no difference in baseline patient characteristics between the two groups. Overall, mean duration between the primary implants and the device exchanges was 413±410 days. Surgical indications included device thrombus/hemolysis (N=18), device malfunction (N=8), and infection (N=2). Cardiopulmonary bypass time was significantly short in the S group (S: 40.2±24.1 min, F: 103.8±92.9 min, p 72hours) (F: N=5, S: N=1, p figure 1 ] Conclusions A subcostal approach is safe and would be preferred for HeartMate II device exchange if indicated.
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