Surgical approach to continuous-flow left ventricular assist device explantation: A comparison of outcomes Andrew C.W. Baldwin, MD, Elena Sandoval, MD,

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Presentation transcript:

Surgical approach to continuous-flow left ventricular assist device explantation: A comparison of outcomes Andrew C.W. Baldwin, MD, Elena Sandoval, MD, George V. Letsou, MD, Hari R. Mallidi, MD, William E. Cohn, MD, O.H. Frazier, MD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 1, Pages 192-198 (January 2016) DOI: 10.1016/j.jtcvs.2015.08.024 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Pump explantation procedures. A, Complete pump explant. After removal of the pump housing (including the inlet cannula), the outflow graft is ligated, and the ventricular sewing ring is occluded with a polytetrafluoroethylene plug. B, Inflow and outflow ligation. The inflow bend relief material is excised to allow ligation of the inner graft and retention of the inlet cannula. The pump housing is removed after similar ligation of the outflow graft. C, Outflow graft ligation. The outflow graft is exposed and ligated through a subxiphoid incision. The driveline is then transected at the level of the skin. D, Driveline transection. The pump is left in place, and the percutaneous driveline is cut at the exit site. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 192-198DOI: (10.1016/j.jtcvs.2015.08.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Kaplan-Meier survival analysis stratified by surgical approach to explantation. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 192-198DOI: (10.1016/j.jtcvs.2015.08.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Time-related depiction of reoperation for infectious causes stratified by surgical approach to explantation. Vertical markings represent reoperative events, with color changes indicating conversion to an alternative explant approach through the removal of additional device material. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 192-198DOI: (10.1016/j.jtcvs.2015.08.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Four techniques for explanting a continuous-flow ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 192-198DOI: (10.1016/j.jtcvs.2015.08.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions