Residual Lung Injury Following HeartMate 3 Explantation for Heart Transplant

Abstract

Left ventricular assist device (LVADs) are commonly used as a bridge to transplantation. The HeartMate 3 (HM 3) is the most recently approved intrathoracic LVAD. Little is known about the impact of HM 3 on adjacent lung tissue, particularly the damage that may occur during HM 3 explantation. We reviewed all HM 3 patients implanted at our center. We identified patients who underwent heart transplant (HT) and investigated post-transplant adverse events, focusing on radiological findings of the left lung (X-ray and / or computed tomography at 1week, 1 month, 3 months, and 6 months). Out of 165 HM 3 patients, 35 patients were transplanted. Mean age was 56(IQR 52, 61), 85.7% male, HT occurred at 289 days (IQR 90, 576), of LVAD support. During follow-up period of 342 days (IQR 242, 686), 33 (94.3%) survived. There were 12 (34.3%) patients who developed pneumonia, and 9 of these occurred within the first 30 days. 57% of the patients had Lt lung consolidation and 83% had left-sided pleural effusion at one week following transplant, and these findings resolved in some but not all of the cohort at 3 months (Table). In our cohort of HM 3 patients bridged to transplantation, there was excellent short and intermediate-term survival. However, a high rate of persistent left lung injury was identified following HT. Further study of the impact of these lung findings on patient morbidity is warranted.