We describe preemptive placement of a TandemHeart percutaneous left ventricular assist device (CardiacAssist Inc, Pittsburgh, PA) through the axillary artery and vein for temporary postoperative support in a patient with severe left ventricular dysfunction undergoing high-risk cardiac reoperation. We believe this approach is preferable to high-dose catecholamines because of preserved early tissue perfusion without excessive vasoconstriction. Axillo-axillary placement is advantageous because patients can sit up and partially mobilize, and there is no need to reopen the chest for explantation.
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.