Expert Consensus Paper: Lateral Thoracotomy for Centrifugal Ventricular Assist Device Implant

Area of Science:

• Cardiovascular Surgery
• Medical Devices

Background:

• Growing prevalence of heart failure necessitates advanced treatments like left ventricular assist devices (VADs).
• Lateral thoracotomy (LT) offers a less invasive approach for VAD implantation compared to traditional sternotomy.
• Lack of standardized guidelines and prospective studies for LT-VAD procedures presents a clinical challenge.

Framework:

• An international expert consensus was developed through a systematic literature review and open discussion.
• The consensus paper provides a comprehensive framework for LT-VAD implantation.

Implementation:

• Guidance on patient selection and preoperative optimization for LT approaches.
• Detailed descriptions of surgical techniques, including hemisternotomy and bilateral thoracotomy.
• Best practices for device placement, cardiopulmonary bypass, and postoperative management are outlined.

Implications:

• Aims to standardize and improve the safety and efficacy of LT-VAD procedures.
• Emphasizes the importance of multidisciplinary teams and specialized training for successful outcomes.
• Facilitates wider adoption of minimally invasive VAD implantation techniques.