Surgical Challenges of Heart Mate 3 Pump Implantation in Aneurysmally Changed Heart Ventricles

Abstract

<jats:p>We presented surgical treatment of three patients indicated for implantation of a permanent mechanical circulatory support device and with the associated left ventricular aneurysms. In order to evade the left ventricular rupture, adverse thromboembolic events and provide safe implantation of the inflow cannula, LVAD HM3 implantation together with the reconstruction of the left ventricular aneurysmal wall was performed in two patients. Regarding the third patient, LVAD implantation upon the reconstruction of the left ventricular wall was abandoned because there was no safe location for placement of the inflow cannula.</jats:p>

Giant Left Ventricular Aneurysm With Dynamic Right Ventricular Compression and Subsequent End-Stage Heart Failure

“…LVAD implantation is reserved for selected cases given the risks associated with aneurysmal myocardial tissue characteristics and potential embolization of intracardiac thrombus. Several cases of successful implantation with 1 , 2 or without 3 LV repair have been reported. Herein, we present a unique complication of LV aneurysm in which mass effect on the right ventricle by the aneurysm caused significant RV dysfunction, further compromising cardiac output and ultimately necessitating transplantation.…”

Left ventricular assist device implantation in left ventricular aneurysm: The turtleneck technique

“…LVAD implantation could be complicated by challenging anatomy such as left ventricular (pseudo) aneurysm. 1 In these patients, concomitant endoventricular patch plasty (Dorr procedure) is performed to reconstruct the left ventricle. 2 , 3 , 4 , 5 The usage of a patch (either pericardial or prosthetic) in the thinned left ventricle could be associated with unstable LVAD positioning and lead to bleeding and thrombotic complications.…”