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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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The Role of Ventricular Assist Devices in Patients with Ischemic vs. Non-Ischemic Cardiomyopathy

Eglė Rumbinaitė1, Dainius Karčiauskas2,3, Grytė Ramantauskaitė1

  • 1Clinical Department of Cardiology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.

Journal of Personalized Medicine
|June 25, 2025
PubMed

Insights

Preoperative right-sided pressures and renal dysfunction predict early mortality after HeartMate 3 left ventricular assist device (LVAD) implantation. Ischemic cardiomyopathy patients show better early recovery than dilated cardiomyopathy patients.

Area of Science:

  • Cardiology
  • Mechanical Circulatory Support
  • Heart Failure Research

Background:

  • The HeartMate 3 (HM3) left ventricular assist device (LVAD) improves outcomes in advanced heart failure (HF).
  • The impact of heart failure etiology (ischemic cardiomyopathy [ICM] vs. dilated cardiomyopathy [DCM]) on HM3 LVAD outcomes needs further clarification.

Purpose of the Study:

  • To assess early outcomes after HM3 LVAD implantation in ICM versus DCM patients.
  • To identify preoperative predictors of mortality and hemodynamic instability post-HM3 LVAD implantation.

Main Methods:

  • Retrospective single-center cohort study of 30 HM3 LVAD recipients (2017-2024).
  • Patients stratified by HF etiology: ICM (n=17) and DCM (n=13).
  • Analysis of preoperative clinical, echocardiographic, and right heart catheterization data; primary endpoint: 30-day survival.

Main Results:

  • Elevated preoperative central venous pressure, right ventricular pressure, and pulmonary vascular resistance predicted mortality.
  • Higher preoperative creatinine and longer cardiopulmonary bypass times were associated with non-survival.
  • Postoperative vasopressor use correlated with elevated pre-implant systolic pulmonary artery pressure.

Conclusions:

  • Preoperative right-sided pressures and renal dysfunction are key predictors of early mortality post-HM3 LVAD.
  • Ischemic cardiomyopathy patients demonstrate superior early left ventricular recovery compared to DCM patients.
  • Personalized preoperative risk stratification, especially for DCM patients with pulmonary hypertension, is crucial for optimizing HM3 LVAD outcomes.

Keywords:
HeartMate 3advanced heart failuredilated cardiomyopathyearly mortalityischemic cardiomyopathyleft ventricular assist devicepulmonary hypertensionright heart failure

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