Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Eur J Cardiothorac Surg. 2017 Dec 1;52(6):1223-1224. doi: 10.1093/ejcts/ezx270.
The HeartWare left ventricular assist device is a miniaturized, continuous centrifugal-flow pump. The implantation technique is well described and relatively standardized across different institutions. However, there still exists a technical concern about handling the inflow cannula at the time of device explant. Specifically, the removal of the sewing ring and plicating the apical defect en masse may distort the geometry of the left ventricle and impart myocardial dysfunction. Additionally, a prefabricated repair mechanism by the manufacturer is not readily available in all countries (i.e. USA). Here, we describe a technique to address the apical core defect, using a tailor-made plug and leaving the sewing ring in situ, at the time of the HeartWare left ventricular assist device explant.
HeartWare 左心室辅助装置是一种微型化、连续离心流泵。其植入技术在不同机构之间有很好的描述和相对标准化。然而，在设备取出时，仍然存在处理流入管的技术问题。具体来说，移除缝合环并将心尖缺陷整块折叠可能会使左心室的几何形状发生变形，并导致心肌功能障碍。此外，制造商提供的预制修复机制并非在所有国家都能轻易获得（例如美国）。在这里，我们描述了一种在取出 HeartWare 左心室辅助装置时，使用定制塞子和保留缝合环原位的方法来处理心尖核心缺陷的技术。
