Robotic-assisted biventricular durable assist device implantation: The first in human experience

We report a novel approach of robotic-assisted, minimally invasive biventricular assist device (BiVAD) implantation using HeartMate 3 in a 61-year-old male with severe biventricular dysfunction due to dilated cardiomyopathy. Robotic assistance enabled sternum-sparing, implantation of both left and right durable ventricular assist devices via left and right thoracotomies. Postoperative recovery was uneventful, and the patient remains clinically stable and discharged home with no device-related complications. This approach allows for a precise dissection and implantation technique in a limited mediastinal space. Preservation of the thoracic cavity (sternum & anterior mediastinum) constitutes a key factor in reducing morbidity and later facilitates subsequent heart transplantation. Our experience supports the feasibility and potential benefits of robotic-assisted BiVAD implantation in appropriately selected patients.