Surgical Technique for Ventricular Device Exchange: From HeartMate II to HVAD

Implantable continuous-flow left ventricular assist devices (LVADs) have improved the survival of end-stage heart failure patients. Recent studies have shown an increased occurrence of device replacement in the axial flow pumps particularly for thrombosis. In some patients, to try and avoid recurrent pump thrombosis, it might be advantageous to switch from the axial flow LVAD to a newer generation centrifugal flow LVAD. Technically, this requires some adaption of the LVAD inflow and outflow connections. We describe our technique and outcomes in patients who underwent the conversion from an axial flow LVAD to a centrifugal flow LVAD.