Journal of Artificial Organs

, Volume 22, Issue 3, pp 188–193 | Cite as

How to implant the Jarvik 2000 post-auricular driveline: evolution to a novel technique

  • Massimiliano CarrozziniEmail author
  • Jonida Bejko
  • Dario Gregori
  • Gino Gerosa
  • Tomaso Bottio
Original Article Artificial Heart (Clinical)


The post-auricular (PA) driveline positioning for percutaneous power delivery is a specific feature of the Jarvik 2000 FlowMaker LVAD. We applied several technical refinements to optimise the PA implant. Here, we present and discuss these modifications. We retrospectively reviewed all patients implanted with Jarvik 2000 at our Institution. Different PA implant techniques were described. A machine learning analysis was performed to evaluate the determinants of driveline infection. From December 2008 to December 2017, 62 patients were implanted with Jarvik 2000, at our Institution. The PA connection was managed through the “question mark-shaped” incision in 24 patients (39%) and with the “C-shaped” in 18 (29%), whereas 10 (16%) cases received the “vertical incision” and 10 (16%) the “orthogonal incision”. The implant technique resulted highly predictive of driveline infection. The rate of driveline infections was numerically lower among cases managed with the last two techniques. After evolving through different implant techniques, we propose and suggest the “orthogonal incision” to maximise the advantages of the Jarvik 2000 post-auricular driveline.


Jarvik 2000 Post-auricular Driveline LVAD Left ventricular assist device 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

Surgical procedure to implant the Jarvik 2000 post-auricular driveline with the “orthogonal incision” (MP4 75822 kb)


  1. 1.
    Westaby S, Siegenthaler M, Beyersdorf F, Massetti M, Pepper J, Khayat A, et al. Destination therapy with a rotary blood pump and novel power delivery. Eur J Cardiothorac Surg. 2010;37:350–6.PubMedGoogle Scholar
  2. 2.
    Bejko J, Toto F, Gregori D, Gerosa G, Bottio T. Left ventricle assist devices and driveline’s infection incidence: a single-centre experience. J Artif Org. 2018;21:52–60.CrossRefGoogle Scholar
  3. 3.
    Hannan MM, Husain S, Mattner F, Danziger-Isakov L, Drew RJ, Corey GR, et al. Working formulation for the standardization of definitions of infections in patients using ventricular assist devices. J Heart Lung Transplant. 2011;30:375–84.CrossRefPubMedGoogle Scholar
  4. 4.
    Carrozzini M, Bejko J, Guariento A, Rubino M, Bianco R, Tarzia V, et al. Minimally invasive implantation of continuous flow left ventricular assist devices: the evolution of surgical techniques in a single centre experience. Artif Organs. 2018. Scholar
  5. 5.
    Breiman L. Random forests. Mach Learn. 2001;45:5–32.CrossRefGoogle Scholar
  6. 6.
    Ishwaran H, Kogalur UB, Blackstone EH, Lauer MS. Random survival forests. Ann Appl Stat. 2008;2:841–60.CrossRefGoogle Scholar
  7. 7.
    Ishwaran H, Kogalur UB, Gorodeski EZ, Minn AJ, Lauer MS. High-dimensional variable selection for survival data. J Am Stat Assoc. 2010;105:205–17.CrossRefGoogle Scholar
  8. 8.
    R Development Core Team. R: a language and environment for statistical computing.Google Scholar
  9. 9.
    Tarzia V, Bortolussi G, Bianco R, Buratto E, Bejko J, Carrozzini M, et al. Extracorporeal life support in cardiogenic shock: impact of acute versus chronic etiology on outcome. J Thorac Cardiovasc Surg. 2015;150:333–40.CrossRefPubMedGoogle Scholar
  10. 10.
    Carrozzini M, Toto F, Gerosa G, Bottio T. Irreversible cardiac failure with intraventricular thrombosis: a novel technique of paracorporeal biventricular assist device implantation with ventricles excision. J Thorac Cardiovasc Surg. 2018;155:1632–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Carrozzini M, Bejko J, Gerosa G, Bottio T. Bilateral mini‐thoracotomy approach for minimally invasive implantation of HeartMate 3. Artif Organs. 2018. Scholar

Copyright information

© The Japanese Society for Artificial Organs 2019

Authors and Affiliations

  1. 1.Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public HealthUniversity of PadovaPaduaItaly

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