Schmitto Jan D, Krabatsch Thomas, Damme Laura, Netuka Ivan
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Department of Cardiac Surgery, German Heart Centre, Berlin, Germany.
J Thorac Dis. 2018 Jun;10(Suppl 15):S1692-S1695. doi: 10.21037/jtd.2018.01.26.
The novel HeartMate 3 (Abbott, Chicago, IL, USA) left ventricular assist device (LVAD) was worldwide first implanted by Prof. Schmitto and his team in 2014 at the Hannover Medical School, Germany and received CE Mark approval in October, 2015 following completion of a clinical trial.
Although HeartMate 3 implantation in the clinical trial was restricted to conventional sternotomy, the small size of the pump allows for less-invasive implantation, generally associated with less trauma and reduced perioperative complication rates. Herein we describe our first experiences with a less-invasive implantation of the HeartMate 3 using an upper hemi-sternotomy combined with anterior lateral thoracotomy approach.
Results demonstrate the feasibility of this novel, less invasive technique for HeartMate 3 LVAD implantation with diminished surgical trauma, less postoperative bleeding, maintenance of the chest stability, reduced need of blood product transfusion and earlier recovery.
The results of our study indicate that less-invasive implantation of the HeartMate 3 is technically feasible and offers several benefits for surgical outcome and may become the standard of care for LVAD implantation techniques.
新型HeartMate 3(美国伊利诺伊州芝加哥雅培公司)左心室辅助装置(LVAD)于2014年由施米托教授及其团队在德国汉诺威医学院首次在全球范围内植入人体,并在完成一项临床试验后于2015年10月获得CE标志认证。
尽管在临床试验中HeartMate 3的植入仅限于传统胸骨切开术,但该泵体积小,允许采用侵入性较小的植入方式,通常创伤较小且围手术期并发症发生率降低。在此,我们描述了我们首次使用上半胸骨切开术联合前外侧开胸术式对HeartMate 3进行微创植入的经验。
结果表明,这种用于HeartMate 3左心室辅助装置植入的新型微创技术是可行的,手术创伤减小,术后出血减少,胸部稳定性得以维持,血液制品输注需求降低,恢复更早。
我们的研究结果表明,HeartMate 3的微创植入在技术上是可行的,对手术结果有诸多益处,可能会成为左心室辅助装置植入技术的护理标准。