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ORIGINAL ARTICLE CARDIAC SECTION
The Journal of Cardiovascular Surgery 2021 December;62(6):646-51
DOI: 10.23736/S0021-9509.21.11756-2
Copyright © 2021 EDIZIONI MINERVA MEDICA
language: English
Three-year follow-up after less-invasive left ventricular assist device exchange to HeartMate 3™
Jasmin S. HANKE, Silvia MARIANI, Ali S. MERZAH, Karl BOUNADER, Tong LI, Axel HAVERICH, Jan D. SCHMITTO, Günes DOGAN ✉
Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
BACKGROUND: Device exchange to a newer generation left ventricular assist device (LVAD) offers the opportunity to benefit from improved adverse events profiles. We present the three-year results of a patient cohort undergoing VAD upgrades to a new generation device focusing on outcomes and adverse events.
METHODS: We present the first series of patients who underwent LVAD upgrade to HeartMate 3™ (Abbott Laboratories; Abbott Park, IL, USA). All operations were performed less invasively. Follow-up time was three years after LVAD exchange.
RESULTS: Overall four HeartMate II™ (Abbott Laboratories; Abbott Park, IL, USA) and two HVAD patients underwent LVAD upgrade. In five cases severe infection of the VAD led to device exchange (83%, 5/6). Three-year survival after LVAD exchange was 100% (6/6). In the follow-up examinations one patient showed a single syncope and several low flow alarms (1/6). The remaining five patients showed no technical malfunctions of the LVAD or hemodynamic adverse events (5/6). Four out of five patients whose devices had to be changed due to an infection suffered a local re-infection (4/5), which did not require any further surgical intervention. Four patients were successfully transplanted, and two patients were still on device support at three years after LVAD exchange.
CONCLUSIONS: Three-year outcomes and adverse events after LVAD exchange to HeartMate 3™ (Abbott Laboratories). show excellent results. The superior hemocompatibility in terms of pump thrombosis makes the HM3 a favored choice in case of LVAD exchange due previous pump thrombosis. However, in cases of exchange due to device infection the risk of re-infection remains high.
KEY WORDS: Heart-assist devices; Thrombosis; Infections