Log in or register to post comments Last Post Fred D. Recipient LVad questions Mon, 06/11/2018 - 2:11PM Hi- just figured out how to find & use this site. 2 questions 1-Anyone know what > 12 Means in both Peak & trough??? 2- open you up chest/ sternum Is there a less invasive operation? Thanks Log in or register to post comments 580 reads #1 Lesley H. Reply to Tackroom Fred Mon, 06/18/2018 - 1:13PM Hi Tackroom Fred, The peak and trough as it relates to LVAD is most likely referring to Coumadin levels. It is important with LVAD not to clot off the pump, so the blood must be monitored extremely closely to insure it is thin enough, but not too thin. I would speak to your physician or LVAD coordinator in your heart failure clinic so that this can be explained in greater detail. As far as the surgery is concerned, LVAD implantation is open heart surgery. It cannot be done without opening the sternum. Although the designs of the devices are getting better and smaller, it does still require that the heart be completely exposed. These surgeries are done by highly qualified and credentialed cardiothoracic surgeons. I hope this helps. #2 In reply to Reply to Tackroom Fred by Lesley H. Fred D. Thanks for your responde Fred Tue, 06/19/2018 - 3:21AM Thanks for your responde Fred #3 In reply to Reply to Tackroom Fred by Lesley H. ron l. Opening sternum Wed, 06/20/2018 - 10:28PM I have read somewhere that Heartware has a much smaller pump and they're implanting it w/o opening the sternum. It's implanted thru the ribs I think.