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.