Internet video of the week : Implantation of the HeartWare HVAD: from full sternotomy to less invasive techniques [1]
Left ventricular assist devices (LVADs) are increasingly used for the treatment of end-stage congestive heart failure, both as a bridge to transplantation and as destination therapy (1 [3]). The HeartWare HVAD (HeartWare Inc, Framingham, MA, USA) is a continuous centrifugal-flow left ventricular assist device with a magnetic levitating rotor pump. The pump weighs just 140 g and its small design allows for intra-pericardial placement. It is powered by two portable batteries that connect to the pump via a driveline tunneled through the abdominal wall, and these can be worn on a belt, allowing out of hospital support (2 [4]). The HVAD is currently indicated for use in patients with refractory end stage congestive heart failure. We outline two techniques for implanting the HeartWare HVAD: via a full median sternotomy, and using minimal access incision