Jarvik 2000: evolution of surgical implantation from conventional to minimally invasive technique.

The Jarvik 2000 is a continuous axial flow left ventricular assist device (LVAD) with an impeller type pump. It has a unique power delivery system, which is tunneled to a retroauricular skull pedestal in order to minimize driveline infections (1). Conventional implantation of the Jarvik 2000 is performed off-pump through a left postero-lateral thoracotomy, with the outflow conduit anastomosed to the descending aorta. An alternative technique is performed through a full sternotomy, on cardiopulmonary bypass, with the outflow graft anastomosed to the ascending aorta (1-3). In both cases, the pump is implanted at the left ventricular apex. We describe an evolution of the Jarvik 2000 implantation technique, using a less invasive approach to surgery and perfusion (4) (Video 1).