Cardiac Transplantation After HeartMate 3 Implantation Inclusive Implantation Tips: Step by Step

Abstract

Heart transplantation is still the primary surgical treatment for end-stage heart failure. Due to limited donor heart availability, alternative and improved strategies are required. The tremendous developments in the field of active left ventricular assist devices (LVADs) have resulted in increased usage of LVADs as a bridge to transplant strategy and pose a technical challenge for LVAD preparation and removal during heart transplantation. The HeartMate 3 is the latest generation of fully magnetically levitated centrifugal left ventricular assist device and can be completely intrapericardially implanted in many different configurations. In this paper, a surgical strategy and technique is described in patients who received a HeartMate 3 LVAD after a classic implantation technique via sternotomy. Additionally, special features and challenges are highlighted for the less invasive implantation and biventricular configuration of 2 continuous flow HeartMate 3 pumps for heart transplantation.