Improved Early Survival With a Nonsternotomy Approach for Continuous-Flow Left Ventricular Assist Device Replacement

In this Duke study, all CF LVAD implantations during the 2005 to 2013 era were analyzed, and those patients who underwent CF LVAD implantation and later replacement were reviewed.  Two groups of patients were compared:  those undergoing VAD replacement via a resternotomy approach (n=20) and those undergoing VAD replacement via a nonsternotomy approach (n=22).  After VAD replacement, the latter group exhibited improved survival and reduced morbidity as compared to the former.  Hence, it may be preferable to replace LVADs via a nonsternotomy approach if concomitant cardiac conditions do not need to be addressed.