Simple implantation of a temporary right ventricular device for right ventricular failure after left ventricular device implantation via a left lateral thoracotomy

Abstract

Right ventricular (RV) support in the case of RV failure after left ventricular assist device (LVAD) implantation is a well-established surgical therapeutic option. However, there is a serious limitation of RV support after the insertion of a LVAD through lateral thoracotomy in patients who have undergone previous multiple cardiac operations. We describe a modified surgical approach for implantation of right ventricular assist devices (RVADs) via left lateral thoracotomy, with venous cannulation via a femoral vein and transpericardial outflow cannulation of the main pulmonary artery by Seldinger technique under echocardiographic monitoring. This technique was successfully used in a case with subsequent weaning from the RVAD after 10 days of support.