HeartWare HVAD Exchange to HeartMate3: Principles, Techniques, and Pitfalls

Abstract

Since the recall of the HeartWare HVAD device in 2021, the management of the remaining implants range from medical management, transplant, to exchange. This article describes 2 feasible approaches to exchange the HVAD to the HeartMate3 device through a combination of a left lateral thoracotomy with a superior hemi-sternotomy. These approaches minimize dissection and complications of a redo-sternotomy and minimizes bypass time. Pitfalls and solutions are also herein described. Since the recall of the HeartWare HVAD device in 2021, the management of the remaining implants range from medical management, transplant, to exchange. This article describes 2 feasible approaches to exchange the HVAD to the HeartMate3 device through a combination of a left lateral thoracotomy with a superior hemi-sternotomy. These approaches minimize dissection and complications of a redo-sternotomy and minimizes bypass time. Pitfalls and solutions are also herein described. Commentary: HeartWare HVAD to HeartMate 3 Device Exchange: Assessing the Technical ChallengesOperative Techniques in Thoracic and Cardiovascular SurgeryPreviewA HeartWare HVAD-to-HeartMate 3 left ventricular device exchange. Full-Text PDF