Hypertrophic cardiomyopathy is known to be difficult to support by left ventricular assist device because of the small ventricular cavity and inadequate drainage. Therefore, instead of cannulating on the left ventricular apex, a HeartWare ventricular assist device (HeartWare, Framingham, MA) was connected to the left atrium through right atrium onto atrial septum using ringed Gore-Tex (W.L. Gore & Associates, Flagstaff, AZ) interposition graft. The patient has been discharged home after ventricular assist device implant and underwent successful heart transplant after 111 days of support without any complications including any thromboembolic events. This new transatrial left atrial cannulation technique can be an alternative approach for ventricular assist device cannulation in hypertrophic cardiomyopathy. It can be safely performed with the HeartWare ventricular assist device.
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