Heartmate vented-electric left ventricular assist system: technique for intrathoracic or intraperitoneal implantation via a left thoracotomy

The HeartMate vented-electric left ventricular assist system (Thoratec Corp., Woburn, MA) has become widely accepted as a temporary bridge to transplantation. We describe a left thoracotomy technique in 3 patients for implanting this pump intrathoracically or intraperitoneally. In all 3 cases, long-term pump function was satisfactory. For HeartMate implantation, the left thoracotomy approach may be particularly useful when previous median sternotomies, coupled with the severe debilitation posed by chronic heart failure and hepatic dysfunction with resultant coagulopathy, would greatly increase the mortality and morbidity of a redo median sternotomy.