HeartMate 3 Implantation Through Left Atrial e-PTFE Conduit for Restrictive Cardiomyopathy

Restrictive or hypertrophic cardiomyopathy presents a challenge to left ventricular assist device placement because of the small left ventricle cavity. Cases have described inflow cannulation of the HeartWare HVAD by expanded polytetrafluoroethylene conduit through the atrial septum to the left atrium. We applied this technique to an adult man with restrictive cardiomyopathy and pulmonary hypertension using the HeartMate 3, which successfully supported the patient and led to significant reduction in pulmonary artery pressure. He received a transplant 3 months later without complications. For select patients, left atrial conduit for HeartMate 3 inflow is a feasible alternative to conventional apical cannulation.