Circulatory support exceeding five years with a continuous-flow left ventricular assist device for advanced heart failure patients

Abstract

Continuous-flow left ventricular assist devices (CF-LVAD) are now providing years of safe circulatory support with enhanced quality of life. We present four cases of patients with advanced heart failure who received support for greater than 5-years with the HeartMate II CF-LVAD. One patient continues with support at 7.5 years and has decided to not undergo cardiac transplantation. Another patient has also had LVAD support for 7.7 years, initially with a pulsatile flow LVAD, and then was switched to the HeartMate II, which has continued to support him for the last 6.6 years. Two other patients have undergone heart transplant after support times of 5.46 years and 5.75 years. Few complications occurred and the patients had very active lifestyles during support. Explant analysis revealed very low bearing wear and minimal pannus.

Less invasive HeartMate 3 left ventricular assist device implantation

“…Less-invasive implantation of the HeartMate 3 is therefore technically feasible, offers several benefits for surgical outcome and may become the standard of care for LVAD implantation techniques (8)(9)(10)(11)(12). Future comparative studies between the techniques are warranted.…”

“…With the growing numbers of patients diagnosed with advanced stage heart failure and a growing acceptance of device therapy, the application of left ventricular assist devices (LVADs) is increasing worldwide (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Technological developments and increased surgical experience has led to significant improvement of circulatory support with LVADs.…”

The association between novel clinical factors and gastrointestinal bleeding among patients supported with continuous‐flow left ventricular assist device therapy

“…Congestive heart failure, a chronic and progressive disease, afflicts more than 5.7 million Americans with an annual incidence of 600 000, killing 280 000 people annually and leaving the remainder with a 5‐year mortality rate of 46% . Among patients with refractory heart failure, left ventricular assist device (LVAD) therapy has emerged as an excellent treatment option, improving both quantity and quality of life . With the advent of axial and centrifugal pump technologies, continuous‐flow LVADs (CF‐LVAD) are now smaller and more durable and have more diagnostic algorithms than previous generations of pumps.…”

Acoustic and afterload evaluation of left ventricular assist devices

“…There are individual case reports that show the long-term benefits and life-saving ability of these devices. 212,213 The adverse events have triggered further improvements in minimizing moving parts that can cause pump failure and minimizing shear stress that leads to platelet activation.…”