A novel approach to stenting a stenotic graft housing a Berlin Heart cannula by utilizing an adapted left ventricular assist device circuit

Background A 9-year-old boy with Berlin Heart biventricular assist device for diagnosis of dilated cardiomyopathy developed progressive reduction in left ventricular assist device(VAD) emptying and evidence of low cardiac output despite alterations to the device settings. Computed tomography revealed that the Dacron graft attaching the systemic cannula to the ascending aorta was stenosed. Method & Result A minimally invasive approach with novel circuit modification was used to achieve antegrade stenting of the stenosed graft. Conclusion This proposed technique provides a large port for minimally invasive access via an adapted VAD circuit allowing stent insertion to the aortic graft with an excellent outcome.