Less Invasive Surgical Approaches for LVAD Implantation -State of the Art.

For several years, the standard implantation strategy of VADs has involved a full sternotomy approach. However, less invasive implantation techniques are now becoming increasingly popular as they are associated with reduction of trauma, blood loss and arrhythmogenic complications as well as a decreased duration of intensive care unit and in-hospital stay. Thus, due to miniaturization and increasing technical improvement of ventricular assist devices, less invasive strategies for implantation, explantation, exchange and concomitant cardiac procedures are on the rise. In this review article, we report on the state of the art of less invasive techniques for implantation, explantation, exchange and combined cardiac procedures of ventricular assist devices.