Minimally invasive implantation of an extracorporeal membrane oxygenation circuit used as a temporary left ventricular assist device: a new concept for bridging to permanent cardiac support.

ABSTRACT

The implantation of cardiac assist devices is associated with poor outcome in patients with multiple organ failure and unknown neurologic status. Therefore, temporary left ventricular assist devices (LVAD) using, for example, extracorporeal centrifugal pumps may provide the chance to further evaluate the patient's clinical course and a potential qualification for implantable LVAD therapy. On the other hand, a main disadvantage of the temporary LVAD implantation is the need for redo surgery, increasing the risk of the final LVAD Implantation. To minimize this drawback of the temporary LVAD implantation, we implanted the temporary LVAD using a minimally invasive technique. The operation was done without cardiopulmonary bypass support, and the temporary LVAD was implanted through upper hemisternotomy and left anterior mini-thoracotomy. The patient recovered from multiple organ failure and was successfully bridged to a permanent LVAD therapy.