Relationship of IFC Position to Surgical Approach
We first compared IFC position after CF-LVAD insertion via CS or LTHS. Our hypothesis was that IFC position would improve with LTHS because the insertion site is determined with the heart in its natural position. We found that LTHS yielded less total malposition magnitude. As shown in Figure 3, this is primarily because several CS patients have larger infero-septal IFC deviations. With both approaches, the most common orientation of the IFC was below the apex-MV axis.
The results are consistent with Stoeckl et al.5, who found that a bilateral thoracotomy approach for CF-LVAD placement resulted in a lower IFC angle on chest radiograph than for CS.