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.