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Outcomes After Heartmate 3 Left Ventricular Assist Device Implantation Using a 10 mm Outflow Graft.
Berhane Worku1,2, Alice Vinogradsky3, Aminat Ibrahim2
1From the Department of Cardiothoracic Surgery, New York Presbyterian Weill Cornell Medical Center, New York, New York.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|June 14, 2024
Summary
Using a smaller 10mm outflow graft in Heartmate 3 device implantation required higher pump speeds and inotropic support. However, this did not negatively impact patient outcomes or survival rates.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Techniques
Background:
- Standard 14mm outflow grafts can be challenging to place during left ventricular assist device (LVAD) implantation due to adhesions or bypass grafts.
- Alternative graft sizes may be necessary in complex surgical cases.
Purpose of the Study:
- To evaluate the use of a 10mm Bioline Fusion graft as an outflow conduit in primary Heartmate 3 LVAD implantations.
- To compare outcomes between patients receiving a 10mm graft versus the standard 14mm graft.
Main Methods:
- Retrospective analysis of 101 patients undergoing primary Heartmate 3 LVAD implantation.
- Comparison of patients receiving a standard 14mm outflow graft (n=78) versus a 10mm Bioline Fusion graft (n=23).
- Analysis of initial postoperative rotor speed-to-flow ratio and vasoactive-inotrope score.
Main Results:
- Patients with the 10mm graft had a significantly higher initial postoperative rotor speed-to-flow ratio (1,472 vs. 1,283 RPM/L/min; p=0.03), indicating increased resistance.
- The 10mm graft group also showed a higher initial postoperative vasoactive-inotrope score (24.1 vs. 17.6; p=0.022).
- Despite these differences, postoperative outcomes, including right ventricular failure and mortality, were similar between the groups.
Conclusions:
- The 10mm Bioline Fusion graft can be utilized in Heartmate 3 LVAD implantation when the standard 14mm graft poses challenges.
- While associated with increased hemodynamic resistance and initial inotropic support needs, the 10mm graft does not appear to compromise short-term patient outcomes.
