Conversion technique of pulsatile-to-continuous flow single vascular assist device

Patients with a congenital heart disease and unfavourable anatomy that are not amenable to the primary correction of the defect might need a ventricular assist device as a bridge to a transplant. Pulsatile paracorporeal ventricular assist devices represent excellent options for supporting these patients with complex conditions. The Berlin Heart EXCOR is a such a paracorporeal pulsatile ventricular device. Pulsatile flow is more physiologic because it resembles the natural circulation pumped by the heart. The Berlin Heart EXCOR is a displacement pump; therefore, the risk for increased haemolysis is greater. If the patient experiences haemolysis despite a change the pump flow rate while on a Berlin Heart EXCOR ventricular assist device, a pump exchange to continuous flow may be beneficial. In this case report, we present a patient with severe haemolysis due to a displacement pump and the step-by-step technique for changing from a pulsatile to a continuous flow ventricular assist device.