Rectus-Sparing Technique for Driveline Insertion of Ventricular Assist Device

• Published in: The Annals of thoracic surgery Vol. 100; no. 5; pp. 1920 - 1922
• Main Authors: Asaki, S. Yukiko, MD, Dean McKenzie, E., MD, Elias, Barbara, RN, Adachi, Iki, MD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.11.2015
• Subjects: Abdominal Muscles - injuries; Cardiothoracic Surgery; Heart-Assist Devices; Humans; Intraoperative Complications - prevention & control; Prosthesis Implantation - adverse effects; Prosthesis Implantation - instrumentation; Prosthesis Implantation - methods; Prosthesis-Related Infections - prevention & control; Rectus Abdominis - surgery; Surgery
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2015.02.138

We present a new technique for driveline insertion of the HeartWare ventricular assist device (HVAD) designed to preserve the integrity of the abdominal wall structure. Because of the size of the HVAD driveline connector (12 mm in diameter: triple the size of the driveline cable), the standard tunneling maneuver can result in tearing of the abdominal wall muscle layer, which is a primary mechanism to prevent ascending driveline infection. We find that our technique is particularly useful in children because their abdominal wall muscles are more fragile and thereby prone to accidental injury with blunt penetration when the standard technique is used.