Impact of the HeartMate 3 continuous-flow left ventricular assist device in patients with small body size. (1st February 2022)

• Record Type: Journal Article
• Authors: Tonai, Kohei; Fukushima, Satsuki; Tadokoro, Naoki; Kainuma, Satoshi; Kawamoto, Naonori; Kakuta, Takashi; Koga-Ikuta, Ayumi; Watanabe, Takuya; Seguchi, Osamu; Tsukamoto, Yasumasa; Fukushima, Norihide; Fujita, Tomoyuki
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 34:Number 5(2022)
• Page Start: 902
• Page End: 908
• Publication Date: 2022-02-01
• Subjects: Small patients -- Ventricular assist device -- Body surface area -- HeartMate 3; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivac012
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: OBJECTIVES: Limited data are available for use of the HeartMate 3 (HM 3) left ventricular assist device in patients with a small body surface area (BSA). Because the HM 3 is currently the sole device available worldwide, we conducted a single-centre retrospective study of patients with a small BSA (<1.5 m 2 ) who underwent HM 3 implantation to better understand the operative and postoperative management. METHODS: This study enrolled 64 consecutive patients who had undergone HM 3 implantation from August 2018 to July 2021. The patients were divided into 2 groups based on their BSA before the operation: BSA of <1.5 m 2 (small BSA group, n = 18) and BSA of ≥1.5 m 2 (regular BSA group, n = 46). The primary study endpoint was survival free of events such as disabling stroke and pump failure. The secondary endpoint was the frequency of adverse events. RESULTS: The average BSA was 1.38 m 2 in the small BSA group. The overall event-free survival rate at 12 months was 100% and 86.7% in the small BSA group and regular BSA group, respectively, and no significant difference was found between the 2 groups (log-rank P = 0.2). The number of cumulative adverse events of death, stroke of any severity, driveline infection, pump infection, ventricular arrhythmia, gastrointestinal Haemorrhage and pump failure was similar between the 2 groups. CONCLUSIONS: The HM 3 was safely implanted in patients with a small BSA, and postoperative outcomes were acceptable regardless of BSA. However, further research is needed to confirm the indications for HM 3 implantation in even smaller patients. Abstract : The HeartMate 3 (HM 3; Abbott, Chicago, IL, USA) left ventricular assist device (LVAD) is an essential treatment choice for a growing number of patients with end-stage advanced heart failure, either as a bridge to heart transplantation or as a destination therapy.