Three-year follow-up after less-invasive left ventricular assist device exchange to HeartMate 3™

Hanke, Jasmin S.; Mariani, Silvia; Merzah, Ali Saad; Bounader, Karl; Li, Tong; Haverich, Axel; Schmitto, Jan D.; Doğan, Güneş

doi:10.23736/s0021-9509.21.11756-2

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…However, some studies indicate that it still poses a risk for infection. 17 Given its recent introduction, our study was unable to capture data on the HeartMate III LVAD, but further studies should focus on its risk of infection compared to earlier devices.…”

Section: Discussionmentioning

confidence: 99%

Infection following CF-LVAD exchange for non-infectious indications: A systematic review and meta-analysis

et al. 2022

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Introduction: Patients on continuous flow left ventricular assist devices (CF-LVADs) often require CF-LVAD exchange. The purpose of this study was to investigate the incidence of infection following CF-LVAD exchange performed for non-infectious indications. Methods: An electronic literature search was performed to identify all studies of patients undergoing CF-LVAD exchange for pump thrombosis or device malfunction. Of 2,698 articles identified, 6 studies with 81 total patients met the inclusion criteria. Cohort-level data were pooled for meta-analysis. Results: Mean patient age was 60 years (95% CI: 41–78), and 74% were male (95% CI: 61–84). Pump thrombosis was the most common indication for exchange in 70% of patients (95% CI: 47–86). Other indications were driveline fracture and electrical malfunction in 21% (95% CI: 5–56) and 12% (95% CI: 4–33) of patients, respectively. Prior to exchange, 95% of patients were on HeartMate II (HM2) LVADs (95% CI: 86–98) and average duration of support for these patients was 27.1 months (95% CI: 9.3–44.8). The majority were placed on a HM2 following exchange (88% (95% CI: 45–98)) versus HM3 (12% (95% CI: 2–55)). Follow-up was an average of 16.4 months (95% CI: 6.8–26.0). Following exchange, 16 of 81 patients developed infection, with pooled mean incidence of 24% (95% CI: 14–38). 30-day mortality was 14% (95% CI: 7–26). Survival at follow-up was 65% (95% CI: 52–76). Conclusions: Infection following CF-LVAD exchange can occur at rates higher than those observed with primary implantation; therefore, effective strategies need to implemented early and consistently to help lower infections rates and help improve outcomes following exchange.

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Section: Discussionmentioning

confidence: 99%

Infection following CF-LVAD exchange for non-infectious indications: A systematic review and meta-analysis

et al. 2022

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“…Moreover, the use a left anterolateral thoracotomy approach often requires using a remnant of the HVAD outflow graft. 33,34 Alternative surgical techniques for securing the Heart-Mate 3 to the left ventricular apex. Other options for securing the HeartMate 3 to the left ventricular apex have been advanced.…”

Section: Device Management and Monitoringmentioning

confidence: 99%

“…Other options for securing the HeartMate 3 to the left ventricular apex have been advanced. 29,30,33,34 Each has important potential benefits and limitations. If full sternotomy or complete replacement of the HVAD sewing ring with the HeartMate 3 apical connector poses unacceptable risk as assessed by the surgical team, the following modifications can be considered.…”

Section: Device Management and Monitoringmentioning

confidence: 99%

“…For the implantation of the HeartMate 3 inflow cannula into the remaining HVAD metallic sewing ring, a sterile rubber seal can be placed around the inflow cannula of the HeartMate 3 to avoid leakage between the HVAD metallic sewing ring and the inflow cannula of the HeartMate 3 29,30,33,34 (Figure E6). The inflow cannula of the new HeartMate 3 can then be placed into the established HVAD metallic sewing ring, and the screw of the HVAD sewing ring can be tightened.…”

Section: Device Management and Monitoringmentioning

confidence: 99%

“…An anterolateral left thoracotomy approach may offer several advantages to the redo-sternotomy approach for device exchange. 33,34 In view of the larger dimensions of the HeartMate 3, a wider incision is generally required when using an anterolateral thoracotomy approach. 33 A major limitation of this approach is that a longer remnant of the HVAD outflow graft is left in place because the graft-to-graft anastomosis is typically performed over the acute margin of the right ventricle just behind the sternum.…”

Section: Device Management and Monitoringmentioning

confidence: 99%

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HVAD to HeartMate 3 left ventricular assist device exchange: Best practices recommendations

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Cowger

Davis

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Left ventricular assist device exchange: a review of indications, operative procedure, and outcomes

Lucertini

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et al. 2023

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Three-year follow-up after less-invasive left ventricular assist device exchange to HeartMate 3™

Cited by 7 publications

References 23 publications

Infection following CF-LVAD exchange for non-infectious indications: A systematic review and meta-analysis

Infection following CF-LVAD exchange for non-infectious indications: A systematic review and meta-analysis

HVAD to HeartMate 3 left ventricular assist device exchange: Best practices recommendations

Left ventricular assist device exchange: a review of indications, operative procedure, and outcomes

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