Minimally Invasive Off-Pump Technique for Temporary Left Ventricular Support
- PMID: 33741783
- DOI: 10.1097/MAT.0000000000001404
Minimally Invasive Off-Pump Technique for Temporary Left Ventricular Support
Abstract
Use of short-term mechanical circulatory support (MCS) for cardiogenic shock has rapidly increased. Most common initial MCS strategies entail institution of peripheral extracorporeal membrane oxygenation (ECMO) or temporary ventricular assist devices. For patients with anatomically small peripheral arteries or insufficient circulatory support, sternotomy and central cannulation techniques may be necessary. These invasive approaches are associated with increased risk of bleeding and other significant complications. We describe a minimally invasive, off-pump technique to provide adequate hemodynamic support and left ventricular unloading, allowing early postoperative ambulation, and ability to easily provide additional right ventricular/ECMO support if needed.
Copyright © ASAIO 2021.
Conflict of interest statement
Disclosure: The authors have no conflicts of interest to report.
References
-
- Jiritano F, Lo Coco V, Matteucci M, Fina D, Willers A, Lorusso R: Temporary mechanical circulatory support in acute heart failure. Card Fail Rev. 6: e01, 2020.
-
- Stretch R, Sauer CM, Yuh DD, Bonde P: National trends in the utilization of short-term mechanical circulatory support: Incidence, outcomes, and cost analysis. J Am Coll Cardiol. 64: 1407–1415, 2014.
-
- Takeda K, Garan AR, Topkara VK, et al.: Novel minimally invasive surgical approach using an external ventricular assist device and extracorporeal membrane oxygenation in refractory cardiogenic shock. Eur J Cardiothorac Surg. 51: 591–596, 2017.
-
- Takeda K, Garan AR, Ando M, et al.: Minimally invasive CentriMag ventricular assist device support integrated with extracorporeal membrane oxygenation in cardiogenic shock patients: A comparison with conventional CentriMag biventricular support configuration. Eur J Cardiothorac Surg. 52: 1055–1061, 2017.
-
- Wang D, Zwischenberger JB, Zhou X, et al.: Development of “plug and play” TransApical to aorta VAD. ASAIO J. 53: 171–175, 2007.