Concomitant Cardiac Surgical Procedures in Patients Undergoing HeartMate 3 Left Ventricular Assist Device...

Area of Science:

• Cardiology
• Cardiac Surgery
• Mechanical Circulatory Support

Background:

• Long-term support with HeartMate 3 (HM3) left ventricular assist device (LVAD) improves outcomes in end-stage heart failure.
• Limited data exists on outcomes for patients undergoing concomitant cardiac surgical procedures (CCSP) during HM3-LVAD implantation.

Purpose of the Study:

• To evaluate the single-center experience with CCSP during HM3-LVAD implantation.
• To compare outcomes between patients who received HM3-LVAD with CCSP and those who received HM3-LVAD alone.

Main Methods:

• A retrospective review of 131 adult patients who underwent HM3-LVAD implantation between December 2016 and April 2022.
• 23 patients underwent HM3-LVAD implantation with CCSP (HM3+CCSP), while 108 underwent HM3-LVAD implantation alone (HM3-only).
• Concomitant procedures included valve repair/replacement, septal defect closure, and others.

Main Results:

• The HM3+CCSP group had a longer mean cardiopulmonary bypass time (155 ± 47 min) compared to the HM3-only group (113 ± 58 min) (P = 0.007).
• Mortality rates at 30 days, 6 months, and 12 months were not significantly different between the HM3+CCSP group (9%, 22%, 26%) and the HM3-only group (6%, 17%, 28%).
• No statistically significant differences in mortality were observed at any time point (P = 0.658, 0.554, 1.000).

Conclusions:

• Concomitant cardiac surgical procedures during HM3-LVAD implantation do not significantly impact short-term or mid-term mortality.
• Patients undergoing HM3-LVAD implantation with CCSP experienced similar survival outcomes to those receiving HM3-LVAD alone.
• This suggests that combining procedures may be a safe option for select heart failure patients.