LVAD implantation to Left Subclavian Artery with Distal Banding: A Novel Technique for Hostile Chest.

Abstract: Patients with hostile chests are often precluded from the use of LVAD therapies for advanced heart failure. We describe a technique for LVAD implantation using a left thoracotomy approach with outflow graft anastomosis to the left subclavian artery and placement of a distal band to the left subclavian artery. Distal banding of the left subclavian artery prevents overcirculation to the left upper extremity. This technique provides an alternative approach for LVAD implantation in patients who otherwise would be deemed inoperable due to hostile chest.