Titanium Fastener Utilization During HeartMate 3 Left Ventricular Assist Device Implantation

Area of Science:

• Cardiovascular Surgery
• Medical Device Technology
• Biomaterials Engineering

Background:

• The HeartMate 3 is a left ventricular assist device (LVAD) requiring secure attachment of its inflow sewing ring.
• Traditional methods for securing the sewing ring involve hand-tied knots, which can be time-consuming.
• Investigating novel, efficient methods for device securement is crucial for improving surgical outcomes.

Purpose of the Study:

• To assess the feasibility of using titanium fasteners for HeartMate 3 inflow sewing ring securement.
• To compare surgical times, specifically cardiopulmonary bypass and total operative durations, between titanium fasteners and hand-tied knots.

Main Methods:

• In vitro assessment of clearance between the sewing ring and HeartMate 3 device for titanium fasteners.
• Retrospective review of 31 patients undergoing HeartMate 3 implantation, divided into hand-tied knot (n=18) and titanium fastener (n=13) groups.
• Standardized cannulation and implantation techniques, with variations only in sewing ring securement method.

Main Results:

• Adequate in vitro clearance was confirmed for titanium fastener use.
• Successful in vivo securement of the inflow sewing ring was achieved with titanium fasteners.
• Cardiopulmonary bypass time was significantly shorter in the titanium fastener group (75 min) compared to the hand-tied group (92 min; P < 0.03).
• Total operative time showed no significant difference between the groups (177 min vs. 193 min; P = 0.513).

Conclusions:

• Titanium fasteners provide an efficient and effective method for securing the HeartMate 3 inflow sewing ring.
• The use of titanium fasteners is associated with reduced cardiopulmonary bypass times.
• Titanium fasteners do not significantly alter total operative time compared to hand-tied knots.