Insertion of a biventricular assist device.

This video tutorial demonstrates the insertion of a temporary biventricular assist device as a bridge to a heart transplant in a patient with end-stage heart failure with decompensation and increasing pulmonary pressure . This technique utilizes cardiopulmonary bypass to maintain hemodynamic stability throughout the procedure. Transesophageal echocardiography is used to guide the correct positioning of the ventricular cannulae. The cannulation sites include the right ventricle and the pulmonary artery for the right ventricular assist device and the left ventricular apex and the ascending aorta for the left ventricular assist device. The patient is weaned off cardiopulmonary bypass as the biventricular assist device flows are increased to the desired level. Following chest closure, the patient can be ambulatory with the device in situ.