HeartMate II Implantation Via Single Incisional Ministernotomy in a Small Young Woman

We report a successful case of less invasive implantation of a HeartMate II in a small young woman. A 34-year-old woman, who developed refractory heart failure associated with chronic myocarditis, underwent implantation of a HeartMate II via T-shaped ministernotomy without any additional incisions. This approach has several unique advantages: all of the procedures can be operated in the same view in the usual fashion with minor modifications; some optional procedures can be easily added during the operation if necessary. To confirm the feasibility and versatility of this approach, we assessed the postimplant pump position by the radiographic parameters. The radiographic assessment showed that those parameters were not significantly different than those in our other normal body-sized patients. There were no adverse events associated with HeartMate II implantation during her follow-up. We consider that this approach has the feasibility and versatility, and can be an alternative approach in cases where the conventional approach is inappropriate for some reason.