Nonsternotomy Approaches to Left Ventricular Assist Device Placement: Combined Left Subcostal-Right Minithoracotomy Technique

Alternative non-sternotomy approaches to implanting left ventricular assist devices have become viable and reproducible alternatives to standard sternotomy approach. This paper outlines the essential steps of the left subcostal- right-minithoracotomy approach for left ventricular assist device implantation. The left subcostal approach offers excellent access to the cardiac apex without disrupting the left chest wall, while the aorta can be easily accessed via a right mini-thoracotomy incision.