Successful replacement of a HeartAssist 5 ventricular assist device with a HeartWare without removal of the original sewing/attachment rings: how to do it.

Despite technological advances in a newer generation of ventricular assist devices (VAD), complications, such as pump thromboses, remain a significant cause of morbidity and indeed mortality in these patients. We present the case of a 34-year old patient who underwent HeartAssist 5 (HA5) implantation as a bridge to cardiac transplant. After an initial uneventful recovery, he developed a pump thrombosis that was refractory to medical treatment. We present the surgical technique used to exchange the HA5 with a HeartWare (HVAD), leaving the old inflow-sewing ring in situ.