Implantation of the HeartMate 3-Description of the Surgical Technique

Implantations of left ventricular assist devices (LVADs) for mechanical circulatory support have increased over the last decade. These LVADs are used not only for bridge-to-transplantation but also frequently for destination therapy. The technology of the modern-generation LVAD with centrifugal pumps has reached a state where technical malfunctions are rather the exception, even when running for more than 6-8 years. The incremental improvements in clinical outcomes using such pumps have led to a worldwide increase in implantation procedures in different patient cohorts. In this article, the surgical implantation technique for the latest-generation of intrapericardial, fully magnetically levitated centrifugal continuous-flow LVADs is described in detail for the HeartMate 3 system. Each step is illustrated by several sketches and surgically important steps are discussed.