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

Jonathan Eisenberger, Shmuel Somer, Eyal Nachum

    The Israel Medical Association Journal : IMAJ
    |May 13, 2024
    PubMed

    Insights

    Concomitant cardiac surgical procedures during HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation showed similar mortality rates compared to HM3-LVAD alone. This study found no significant difference in 30-day, 6-month, or 12-month survival for patients undergoing both procedures.

    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.
    Abstract

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