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LVAD Surgical Implant Technique: Infradiaphragmatic Approach

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Mechanical Circulatory Support for Advanced Heart Failure

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Abstract

Inserting the inflow cannula into the left ventricular apex was a technique developed in the era of pulsatile left ventricular assist devices (LVADs). Despite the evolution to continuous flow devices, this technique has remained popular. However, an apical location can make patients vulnerable to arrhythmias and obstruction due to interaction with the ventricular septum. We developed a method for implanting the HeartMate II, HVAD, and HM3 LVAD along the diaphragmatic surface of the heart. The resulting parallel orientation between the inlet cannula and interventricular septum minimizes the risk of inflow disruption and myocardial irritation and also eliminates the need for a pump pocket.

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References

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Disclosures

None of the authors has any commercial conflicts of interest.

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Authors and Affiliations

  1. Division of Cardiothoracic Transplantation, Texas Heart Institute at Baylor St. Luke’s Medical Center, Baylor College of Medicine, Houston, TX, USA

    Jeffrey A. Morgan M.D.

  2. Center for Cardiac Support, Texas Heart Institute at Baylor St. Luke’s Medical Center, Baylor College of Medicine, Houston, TX, USA

    Jeffrey A. Morgan M.D.

  3. Mechanical Circulatory Support and Cardiac Transplantation, Texas Heart Institute at Baylor St. Luke’s Medical Center, Baylor College of Medicine, Houston, TX, USA

    O. H. Frazier M.D.

Authors
  1. Jeffrey A. Morgan M.D.
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  2. O. H. Frazier M.D.
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Corresponding author

Correspondence to Jeffrey A. Morgan M.D. .

Editor information

Editors and Affiliations

  1. Division of Cardiothoracic Transplantation, Surgical Director, Mechanical Circulatory Support and Cardiac Transplantation, Texas Heart Institute at Baylor St. Luke’s Medical Center, Baylor College of Medicine, Houston, Texas, USA

    Jeffrey A. Morgan

  2. Medical Director, Heart Transplant Program, Co-Director, Advanced Heart Failure Center, Texas Heart Institute at Baylor St. Luke’s Medical Center, Baylor College of Medicine, Houston, Texas, USA

    Andrew B. Civitello

  3. Center for Cardiac Support, Texas Heart Institute at Baylor St. Luke’s Medical Center, Baylor College of Medicine, Houston, Texas, USA

    O.H. Frazier

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Morgan, J.A., Frazier, O.H. (2018). LVAD Surgical Implant Technique: Infradiaphragmatic Approach. In: Morgan, J., Civitello, A., Frazier, O. (eds) Mechanical Circulatory Support for Advanced Heart Failure . Springer, Cham. https://doi.org/10.1007/978-3-319-65364-8_6

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  • DOI: https://doi.org/10.1007/978-3-319-65364-8_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65363-1

  • Online ISBN: 978-3-319-65364-8

  • eBook Packages: MedicineMedicine (R0)

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