[Conversion Surgery from Extra-corporeal to Implantable Ventricular Assist Devices].

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Transplantation Medicine

Background:

• Extra-corporeal Ventricular Assist Devices (VADs), such as the Nipro VAD, are vital for patients with severe cardiogenic or post-cardiotomy shock ineligible for heart transplantation.
• Conversion to an implantable VAD (iVAD) is often necessary for patients stabilized on Nipro VAD therapy who are candidates for heart transplantation or destination therapy.
• Successful transition to an iVAD facilitates patient recovery and return to social life.

Purpose of the Study:

• To summarize critical considerations for successful conversion surgery from Nipro VAD to iVAD.
• To provide practical guidance for surgeons performing this specialized procedure.
• To highlight strategies for minimizing complications during VAD conversion.

Main Methods:

• The manuscript outlines three essential tips for successful Nipro VAD to iVAD conversion surgery.
• Emphasis is placed on proactive surgical planning during initial Nipro VAD implantation.
• Recommendations include patient recovery assessment and infection prevention protocols.

Main Results:

• Successful conversion surgery requires careful planning during the initial Nipro VAD implantation, including protecting mediastinal structures and limiting dissection.
• Performing conversion surgery only after complete patient recovery from the initial VAD procedure is critical.
• Preventing iVAD infection by addressing existing Nipro VAD exit site infections is paramount.

Conclusions:

• Conversion surgery from Nipro VAD to iVAD is an essential procedure for select patients.
• Key factors for success include meticulous initial implantation, appropriate surgical timing, and rigorous infection control.
• Dissemination of best practices from experienced institutions is needed due to the limited case numbers of this procedure.