References
  1. Mehra MR, Uriel N, Naka Y, et al. A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report. N Engl J Med. 2019 Apr 25;380(17):1618-1627
  2. Mehra MR, Salerno C, Naka Y, et al. A tale of the twist in the outflow graft: An analysis from the MOMENTUM 3 trial. J Heart Lung Transplant. 2018 Nov;37(11):1281-1284.
  3. Potapov EV, Netuka I, Kaufmann F, Falk V, Mehra MR. Strategy for surgical correction and mitigation of outflow graft twist with a centrifugal-flow left ventricular assist system. J Heart Lung Transplant. 2018 May;37(5):670-673.
  4. Schmitto JD, Hanke JS, Rojas SV, Avsar M, Haverich A. First implantation in man of a new magnetically levitated left ventricular assist device(HeartMate III). J Heart Lung Transplant. 2015;34(6):858-860.
Figure legends:
Figure 1A,1B:Computed tomography showed an outflow graft twist(white arrow)
Figure 1C:The graft angiography showed a graft twisting(white arrow)
Figure 1D,1E:A pull back pressure measurement showed a significant gradient before(white arrow) and after(white arrow head) the twisting
Figure 2A: Subcostal approach. A Rultruck retractor was useful to lift the rib and expose the surgical field.
Figure 2B: Graft twisting.
Figure 2C:The graft is being untwisted with a curved-up Rongeur forceps.
Figure 2D:The graft was untwisted and fixed.