Implanting the HeartMate 6 (total artificial heart)

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Cardiology

Background:

• The HeartMate 3 is a centrifugal continuous flow ventricular assist device with a fully levitated rotor designed to minimize hemolysis.
• It is typically implanted as an apical intrapericardial device and can serve as a bridge to transplant, recovery, or destination therapy.

Observation:

• A 35-year-old patient diagnosed with Yamaguchi syndrome (apical hypertrophic cardiomyopathy) presented with secondary pulmonary hypertension, precluding heart transplantation.
• Conventional left ventricular assist device implantation was not feasible due to the patient's underlying pathology.

Findings:

• Two HeartMate 3 devices were implanted as a total artificial heart (HeartMate 6) to serve as a bridge to transplant therapy.
• A CardioMEMS HF System was concurrently implanted for pulmonary artery pressure monitoring.

Implications:

• This case demonstrates the successful application of the HeartMate 6 configuration in a complex patient unsuitable for traditional VAD implantation or heart transplant.
• This innovative surgical approach expands therapeutic options for patients with end-stage heart failure and contraindications to standard treatments.