Reinforcement of HeartMate II bend relief connection: champagne bottle technique

HeartMate II (Thoratec Corp, Pleasanton, CA) continuous-flow ventricular assist devices may be exchanged through a subcostal approach, where the device body can be accessed easily and safely. The existing bend relief needs to be reattached to the new device body at the end of the operation, and this reattachment often results in a malalignment between the outflow graft, the bend relief, and the device body. This causes unexpected detachment and subsequent graft kinking. We present a new, simple technique to reinforce the bend relief connection.