Less Invasive Left Ventricular Assist Device Implantation With the Furoshiki Technique

In recent years, a less invasive approach has progressively become the first choice for left ventricular assist device (LVAD) implantation. However, in the setting of bridge to transplantation, device-related dense adhesions, particularly at the thoracotomy site, still remain a cumbersome problem at the time of heart transplantation. We propose a technique termed "Furoshiki" with the double wrapping of the LVAD at the primary less invasive implantation consisting of complete wrapping of the LVAD with expanded polytetrafluoroethylene as the first step and complete closure of the pericardial continuity with bovine pericardial patch plasty as the second step.