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Pregnancy and Delivery Care for a Patient With a HeartMate 3
Sara I Jones1, Heather Acuff2, Ryan Best2
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA.
JACC. Case Reports
|June 6, 2025
Summary
Pregnancy after HeartMate 3 left ventricular assist device (LVAD) implantation is rare but possible. This case study highlights a successful pregnancy and live birth with an HM3 LVAD, emphasizing careful management.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Medical Device Technology
Background:
- Limited data exists on pregnancies with left ventricular assist devices (LVADs) in situ, with high maternal and fetal/neonatal morbidity and mortality.
- The HeartMate 3 (HM3) is the primary LVAD in the US, known for improved patient outcomes compared to earlier models.
Observation:
- A 32-year-old woman with a destination-therapy HM3 LVAD became pregnant 19 months post-implantation.
- She received uncomplicated antepartum care and delivered via cesarean section at 34 weeks gestation under neuraxial anesthesia.
Findings:
- This is the second reported case of an HM3-supported pregnancy resulting in a live birth.
- A collaborative anticoagulation plan successfully avoided hemorrhagic or thrombotic complications.
- The intrapartum monitoring strategy ensured patient safety and a positive delivery experience.
Implications:
- Successful pregnancies with HM3 LVADs are achievable with multidisciplinary care.
- Careful management of anticoagulation and intrapartum monitoring are crucial for positive outcomes.
- This case contributes to the growing evidence supporting pregnancy in LVAD patients.
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