A modified explant technique of HeartWare ventricular assist device for bridge to recovery

The HeartWare left ventricular assist device is a miniaturized, continuous centrifugal-flow pump. The implantation technique is well described and relatively standardized across different institutions. However, there still exists a technical concern about handling the inflow cannula at the time of device explant. Specifically, the removal of the sewing ring and plicating the apical defect en masse may distort the geometry of the left ventricle and impart myocardial dysfunction. Additionally, a prefabricated repair mechanism by the manufacturer is not readily available in all countries (i.e. USA). Here, we describe a technique to address the apical core defect, using a tailor-made plug and leaving the sewing ring in situ, at the time of the HeartWare left ventricular assist device explant.