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Related Experiment Video

Updated: May 8, 2026

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

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Continuous-flow left ventricular assist device exchange: clinical outcomes.

Takeyoshi Ota¹, Halit Yerebakan¹, Hirokazu Akashi¹

¹Division of Cardiothoracic Surgery, Department of Surgery, New York, New York.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation

|August 14, 2013

Summary

The subcostal approach for HeartMate II left ventricular assist device (LVAD) exchange is associated with shorter cardiopulmonary bypass times, reduced bleeding, and shorter ICU stays compared to full sternotomy.

Keywords:

device exchange device malfunction device thrombus left ventricular assist device minimally invasive subcostal approach

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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

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Published on: August 16, 2021

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Published on: May 11, 2018

Area of Science:

Cardiology
Cardiovascular Surgery
Medical Devices

Background:

Left ventricular assist device (LVAD) exchange is a necessary procedure for some patients.
Limited research exists on optimal surgical approaches for LVAD exchange.

Purpose of the Study:

To compare the outcomes of LVAD exchange using a subcostal approach versus a full sternotomy.
To evaluate the safety and efficacy of the subcostal approach for HeartMate II device exchange.

Main Methods:

Retrospective review of 30 HeartMate II device exchanges from 2004-2012.
Patients were divided into subcostal (S group, N=16) and full sternotomy (F group, N=14) groups.
Data on perioperative outcomes and complications were analyzed.

Main Results:

The subcostal group had significantly shorter cardiopulmonary bypass times (40 vs. 105 minutes) and less postoperative bleeding (362 vs. 1286 ml).
ICU length of stay was significantly shorter in the subcostal group (4.6 vs. 8.2 days).
Prolonged intubation occurred more frequently in the full sternotomy group (43% vs. 6.3%).

Conclusions:

The subcostal approach for HeartMate II LVAD exchange offers significant perioperative advantages.
This approach may be preferred when indicated for LVAD device exchange.