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Left Atrial Decompression With the HeartMate3 in Heart Failure With Preserved Ejection Fraction: Virtual Fitting and
Xiangyu He1, Moritz Bender1,2, Christoph Gross1
1From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|October 13, 2023
Summary
Left atrial decompression using the HeartMate 3 device shows promise for treating heart failure with preserved ejection fraction (HFpEF). In silico and in vitro studies suggest anatomical compatibility and hemodynamic efficacy in HFpEF patients.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Heart failure with preserved ejection fraction (HFpEF) presents a significant unmet clinical need.
- Previous attempts at left atrial decompression for HFpEF were hindered by patient heterogeneity and lack of specialized devices.
Purpose of the Study:
- To assess the feasibility of using the HeartMate 3 (HM3) device for left atrial decompression in HFpEF patients.
- To evaluate both the anatomical compatibility and hemodynamic effectiveness of the HM3 in an HFpEF context.
Main Methods:
- Virtual implantation of the HM3 device into the left atrium of 10 HFpEF patients via the left atrial appendage (LAA) and left atrial posterior wall (LAPW).
- Experimental investigation of hemodynamic efficacy using a hybrid mock loop simulating HFpEF conditions at rest and during exercise.
Main Results:
- The HM3 demonstrated high anatomical compatibility, with successful virtual implantation through the LAA in 90% and LAPW in 100% of cases.
- Hemodynamic analysis showed normalization of left atrial pressures at rest (approx. 5400 rpm) and required higher speeds (6400-7400 rpm) during exercise simulations.
Conclusions:
- Left atrial decompression with the HM3 device appears anatomically feasible for HFpEF patients.
- The HM3 shows potential hemodynamic efficacy for managing HFpEF, particularly under exercise conditions.
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