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Minimally invasive left ventricular assist device implantation: optimizing device design for this approach
Anamika Chatterjee1, Silvia Mariani1, Jasmin S Hanke1
1Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Expert Review of Medical Devices
|March 3, 2020
Summary
Minimally invasive left ventricular assist device (LVAD) implantation offers a promising approach to reduce complications in heart failure patients. Advances in device design and surgical techniques are paving the way for less invasive procedures.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Global heart failure (HF) burden is increasing due to aging populations and lifestyle changes.
- Mechanical circulatory support (MCS) devices, like left ventricular assist devices (LVADs), are crucial for end-stage HF.
- LVADs offer short-term and long-term circulatory support.
Purpose of the Study:
- To discuss clinical and technological advancements in minimally invasive LVAD implantation.
- To highlight how miniaturization of MCS devices enables less invasive procedures.
- To address the potential for improved patient outcomes by reducing postoperative complications.
Main Methods:
- Review of recent developments in MCS technology, focusing on LVADs.
- Discussion of minimally invasive surgical techniques for LVAD implantation.
- Analysis of factors contributing to the success of these techniques.
Main Results:
- Minimally invasive LVAD implantation, often via thoracotomy, can overcome complications associated with traditional sternotomy.
- Optimized LVAD pump design, cannula insertion, and graft management are key to successful minimally invasive procedures.
- These techniques may reduce postoperative issues like infections, right heart failure, and bleeding.
Conclusions:
- Minimally invasive LVAD implantation is a beneficial option for many heart failure patients.
- Thoracotomy approaches are viable for initial implantation, pump exchange, and explant.
- Future directions include further less-invasive approaches and integration of smart technologies.
