LVAD Takedown - (Outflow Occlusion)
From Bay Area Structural Heart Wiki
Performed when an LVAD patient has cardiac recovery and the LVAD is being decommissioned.
| LVAD Outflow Graft Occlusion and Decommission | |||||
|---|---|---|---|---|---|
| Anesthesia | Imaging | Access | Prep and Drape | Extra Tidbits | |
| General | Fluoro, TEE | 8F Femoral Artery | Prep out LVAD driveline and square off. Drape groins in standard fashion, covering driveline drapes.
When time to access driveline MD will cut out top drape to access driveline. |
DO NOT DC HEPARIN ON CALL TO CCL.
Need 1g of Vancomycin Powder for pocket. | |
Equipment for Outflow Graft Occlusion
- Mircopuncture
- 7For 8F 90cm Shuttle sheath (Sheath depending on plug size)
- 5F MP
- Rosen
- AVP2
- Perclose
- Probe Cover
- Manifold with contrast line
Procedure for Outflow Graft Occlusion
- Shuttle Sheath advanced
- if using 8F, will preclose first
- Rosen advanced, may use MP if difficulty cannulating graft
- Shuttle tunneled into graft
- Plug advanced and deployed
- Groin closure
Equipment for Driveline Transection and Internalization
- Double action rib cutter
- Pacemaker Tray
- 15 blade
- Bovie
- (2) 3-0 Vicryl
- (2) 4-0 Vicryl
- 1g Vancomycin Powder in cup
- Dermabond
Procedure for Driveline Transection and Internalization
- Skin incision
- Driveline transected
- Driveline severed with double action rib cutter
- Driveline Internalized
- Vancomycin sprinkled in pocket
- Pocket closed
- Dermabond applied.
