HeartWare HVAD Exchange to HeartMate3: Principles, Techniques, and Pitfalls

Abstract

Since the recall of the HeartWare HVAD device in 2021, the management of the remaining implants range from medical management, transplant, to exchange. This article describes 2 feasible approaches to exchange the HVAD to the HeartMate3 device through a combination of a left lateral thoracotomy with a superior hemi-sternotomy. These approaches minimize dissection and complications of a redo-sternotomy and minimizes bypass time. Pitfalls and solutions are also herein described.