Device Exchange to HeartMate 3 LVAD: Impact of Previous Pump Model on Clinical Outcomes

Abstract

BackgroundWe describe our clinical experience performing device exchange from a HeartMate II (HM2) or HVAD to a HeartMate 3 (HM3) left ventricular assist device. MethodsA single-center retrospective study was performed of all patients (N = 14) who underwent a left ventricular assist device exchange from HM2 (n = 7) or HVAD (n = 7) to HM3 between October 2018 and October 2021. The primary outcome was 1-year overall survival, and secondary outcomes included adverse events through discharge. ResultsAll patients (median age, 59 years; 29% female) were destination therapy and required urgent device exchange because of pump failure. Although statistically insignificant, the 1-year overall survival was worse in the HVAD to HM3 group compared with the HM2 to HM3 cohort (57% vs 100%, respectively; P = .19). The HVAD to HM3 group also experienced significantly more acute right-sided heart failure requiring right ventricular assist device support (71% vs 0%; P = .02), ventilator days (11 days vs 1 day; P = .001), and reoperation (100% vs 14%; P = .004). ConclusionsPatients being considered for device exchange from HVAD to HM3 may have a more complicated clinical course compared with HM2 to HM3 patients.