Implantable LVAD Insertion in Patients with Previous Heart Surgery

Patrick M. McCarthy*, Nicholas G. Smedira

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Implantable LVAD insertion and support poses technical obstacles in patients with previous heart operations. In this study of 135 LVAD patients (64 pneumatic HeartMate; 39 vented-electric HeartMate; 32 Novacor devices), 72 (53%) had previous heart surgery. For patients with previous coronary artery bypass, the grafts were managed by replacement or preservation. For patients with ventricular aneursym (or aneursmysectomy), or partical left ventriculectomy, apical cannulation had to be modified to maintain precise unobstructed orientation of the inflow cannula towards the mitral valve. Mechanical mitral and aortic prostheses were rereplaced with tissue valves. Implantable cardioverter defibrillators were removed, or the LVAD pump was placed intraperitoneal and the generator was left in the abdominal wall pocket. There were no significant differences in reoperations for bleeding (22% primary vs 23% reoperations), perioperative RVAD support (12% primary vs 7% reoperation) or survival to transplant (82% primary vs 72% reoperations). In conclusion adjustment of standard LVAD implant technique can successfully manage most problems posed by patients with previous heart surgery.

Original languageEnglish (US)
Pages (from-to)S95-S100
JournalJournal of Heart and Lung Transplantation
Volume19
Issue number8
DOIs
StatePublished - Aug 10 2000

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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