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Long-term follow-up of patients supported with the HeartWare left ventricular assist system

Eyad Al Masri1, Mosab Al Shakaki1, Henryk Welp1

  • 1Department of Thoracic and Cardiovascular Surgery, University Hospital Münster, Muenster, Germany.

Artificial Organs
|March 28, 2020
PubMed

Insights

This study reports long-term HeartWare Ventricular Assist System (HVAD) experience in 103 patients. HVAD implantation demonstrated satisfactory long-term survival, with 25% still supported after a median of 2.05 years.

Area of Science:

  • Cardiology
  • Medical Devices
  • Surgical Technology

Background:

  • Heart failure management often requires advanced mechanical circulatory support.
  • Left ventricular assist devices (LVADs) are crucial for end-stage heart failure.
  • The HeartWare Ventricular Assist System (HVAD) is a widely used LVAD.

Purpose of the Study:

  • To present long-term outcomes and survival data for patients receiving HVAD implantation.
  • To evaluate the safety and efficacy of HVAD as a bridge to transplantation (BT), destination therapy (DT), and bridge to decision.

Main Methods:

  • A single-center retrospective study of 103 patients implanted with HVAD between July 2009 and February 2018.
  • Analysis of patient demographics, preoperative conditions (including cardiogenic shock and ECLS use), implantation indications, survival rates, and adverse events.
  • Kaplan-Meier survival analysis was performed for overall, BT, and DT cohorts.

Main Results:

  • Overall survival rates at 1, 2, 4, and 8 years were 69.7%, 56.7%, 46.0%, and 25.0%, respectively.
  • Gastrointestinal bleeding was the most common adverse event; disabling stroke and pump thrombosis occurred in 18.4% and 5.8% of patients, respectively.
  • Long-term survival was satisfactory, with 25.24% of patients still on LVAD support at the latest follow-up, including two patients supported for over 8 years.

Conclusions:

  • The HeartWare Ventricular Assist System (HVAD) provides satisfactory long-term survival for patients with advanced heart failure.
  • HVAD is a viable option for bridge to transplantation and destination therapy, with acceptable adverse event rates.
  • Further multicenter studies are warranted to validate these single-center findings and long-term performance of the HVAD.

Keywords:
ECLSLVADheart failure

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