A Comparison between HeartMate II and HeartWare LVAD, a Single Center Experience

Abstract

Purpose LVAD implantation is an established therapy for end-stage cardiac failure. The most implanted devices are HeartMate II (HMII) and HeartWare (HW). The goal of this study is to compare both devices in terms of morbidity and mortality. Methods and Materials Since 2007 100 HMII and 97 HW LVAD’s are implanted in our center. The mean age in the HW group was lower (51.0 vs 57.4, p=0.001), more patient were ventilated preoperatively (30.9% vs 13%, p=0.002), ECMO support was more frequent in the HW group (16.5% vs 6%, p=0.019). Both groups did not show differences in Intermacs levels, hemodynamic parameter, gender, blood parameters, intention to treat and cause of cardiac failure. Results Operation duration, blood loss and the need for blood transfusion were comparable in both groups. The mean duration of ICU stay postoperatively did not show a difference. Early and late right heart failure (p=0.804, p=0.602) as the need for RVAD implantation were comparable (p=0.296). Driveline infection occurred in 24.7% of the patients in the HW group vs 19% in the HMII group (p=0.66). 8.2% of the patients in the HW group vs 8.4% in the HMII group suffered an embolic CVA (p=0.965), hemorrhagic CVA were comparable (10.3% HW group, 9.5%HMII group, p=0.846). Thrombolysis, because of pump thrombosis, was performed in 3.1% in the HW group, 4.0% in the HMII group (n.s.), replacement was necessary in 3.1% of the HW patients vs 9.0% of the HMII patients (n.s.). One year mortality was 69.8% in the HW group vs 67.3% in The HMII group (n.s.). Conclusions Despite more riskfactors for morbidity and mortality in the HW group (Ventilation, ECMO preoperatively), the results were comparable for the HW and the HMII group. Both devices are feasible, HW seems to have advantages in ECMO patiens and patients on ventilation.