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Ann Thorac Surg 2003;75:297
© 2003 The Society of Thoracic Surgeons

How to do it

Stapled explant of the Jarvik 2000 left ventricular assist device

Michael K. Banbury, MDa*

a Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Accepted for publication July 22, 2002.

* Address reprint requests to Dr Banbury, The Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F24, Cleveland, OH 44195, USA
e-mail: banburm{at}ccf.org

Currently the most common indication for placement of a left ventricular assist device is as a bridge to heart transplantation. One of the new generation axial flow left ventricular assist devices is the Jarvik 2000. This device is placed in the apex of the left ventricle and the outflow graft passes through the left pleural space and is anastomosed to the descending thoracic aorta. The course of the outflow graft presents technical challenges during explant for heart transplantation. Opening the posterior pericardium and use of a vascular stapler to control the outflow graft at the level of the descending thoracic aorta facilitates easy explantation.




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