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.