Placement of Long-term Implantable Ventricular Assist Devices Without the Use of Cardiopulmonary Bypass

Background

Implantation of ventricular assist devices for cardiac support is normally performed using cardiopulmonary bypass. Post-operative complications could be minimized by the placement of these devices without the use of cardiopulmonary bypass.

Methods

We hypothesize that left ventricular assist devices (LVADs), in selected patients, can be implanted safely off-pump.

Results

In 25 patients, LVADs were implanted off-pump (mean age 50 years; 64% male, 36% female; average left ventricular ejection fraction 15%). Pre-operatively 68% of patients were on inotropes, 25% had an intra-aortic ballon pump, and 44% had a previous sternotomy. Blood utilization intra- and post-operatively was relatively minimal with 1 re-exploration for bleeding. There were 3 deaths.

Conclusions

We describe a technique for successful placement of a left ventricular assist device without the use of cardiopulmonary bypass.