Driveline site infections are a common complication following ventricular assist device (VAD) placement but infectious complications at the prior pump inflow site rarely occur 1,2,3. That said, VAD pump explantation due to complications or myocardial recovery are becoming more common in this population as patients are living longer with contemporary centrifugal VAD technology 4. The current literature is limited in terms of risk for reoperation and an optimal surgical approach to prevent early or long term post-operative infectious complications 3,5,6. We present a case series of three VAD explants resulting in remote pump site complications following explant using various techniques: 1) outflow graft transection with VAD inflow cannula plug placement and 2) transection of the inflow graft after removal of silastic cover using a combined left subcostal and anterior thoracotomy. A summary of the combined case timelines is noted in Figure 1.