Left Ventricular Assist Device Implantation to the Left Subclavian Artery With Distal Banding: A Novel Technique for Hostile Chest.

Patients with hostile chests are often precluded from the use of left ventricular assist device therapies for advanced heart failure. We describe a technique for left ventricular assist device 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 over-circulation to the left upper extremity. This technique provides an alternative approach for left ventricular assist device implantation in patients who otherwise would be deemed inoperable because of hostile chest.