Flow Pattern of Artificial Pulse in Outflow Graft of the HeartMate 3 Left Ventricular Assist Device

Abstract

<h3>Introduction</h3> The HeartMate 3 (HM3) is a widely used mechanical circulatory support device designed for patients with advanced left ventricular failure. A feature of the HM3, called artificial pulse, which changes the fixed speed of the rotor 30 times/min in cyclical fashion promotes pump washout and partially restores arterial pulsatility. Despite its increased utilization, little is known about the flow pattern of this artificial pulse in the outflow graft of the HM3. In what follows, we show the spectral Doppler profile of the outflow graft in a patient with a HM3. <h3>Case Report</h3> A 40-year-old male with a history of non-ischemic cardiomyopathy and stage D heart failure was admitted for cardiogenic shock. The patient underwent HM3 implantation for bridge-to-decision therapy. Transesophageal echocardiogram demonstrated a ventricular assist device (VAD) cannula in the appropriate position at a LVAD speed of 5,000 revolutions per minute. The spectral Doppler analysis revealed a periodic cyclic reduction in peak velocity followed by an increase in peak velocity (Figure). This echocardiographic finding suggests that the artificial pulse system was functioning properly and that the outflow graft was patent. <h3>Summary</h3> This is the first case report showing the flow pattern of artificial pulse in outflow graft of the HM3. In patients where the outflow graft can be visualized and interrogated, analysis of the flow pattern can assist in assessing the function of the HM3.