Different surgical strategies for implantation of continuous-flow VADs—Experience from Deutsches Herzzentrum Berlin

Objective: This manuscript summarizes our surgical experience with the implantation of recent continuous-flow left ventricular assist devices (LVADs), with special emphasis on the HeartWare HVAD pump.
Methods: The HeartWare HVAD is, in our experience currently implanted in four different techniques: (I) “Classical” LVAD implantation with heart-lung machine and median sternotomy; (II) “Minimally-invasive” implantation without sternotomy and without heart-lung machine; (III) “Lateral implantation” to the descending aorta; (IV) Using two continuous-flow LVADs for implantable biventricular support.
Results: Five-hundred and four HeartWare HVADs have been implanted using the described techniques in our institution up to now.
Conclusions: The HeartWare HVAD is a versatile device. It has been found to be eminently suited to these four different modes of implantation.