Off Pump Robotic-Assisted LVAD (HeartWare, HVAD) Placement via Left Mini Thoracotomy

Patients who require left ventricular assist device (LVAD) placement frequently either have had previous cardiac surgery or will require future sternotomy. As a result, approaches to avoid sternotomies have been explored. Our group has had success with robotic-assisted left mini anterior thoracotomy placement of LVADs. This approach has the advantage of allowing the graft to lie in an anatomic location while avoiding the morbidity associated with a redo median sternotomy. Here we describe our technique, which can be easily adopted by those with experience in robotic-assisted thoracic procedures as well as with LVAD placement through a hemisternotomy and anterior thoracotomy.