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Hemocompatibility and Long-Term Outcomes in HeartWare Versus HeartMate II Versus HeartMate 3: Multicenter Real-World
Hamza H H Ben Nasir1,2, Ahmed F A Mohammed2,3, Omar Allham4
1Department of Anesthesiology and Operative Intensive Care, Klinikum Links der Weser gGmbH, Bremen, Germany.
Artificial Organs
|January 4, 2026
Summary
The HeartMate 3 (HM3) left ventricular assist device (LVAD) shows improved survival and reduced thromboembolic events compared to HeartMate II (HMII) and HeartWare (HVAD). Bleeding risks were similar across all continuous-flow LVADs.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Medical Devices
Background:
- Left ventricular assist devices (LVADs) are crucial for end-stage heart failure.
- Comparing third-generation (HeartMate 3) with second-generation LVADs (HeartMate II, HeartWare HVAD) is essential for clinical practice.
Purpose of the Study:
- To compare overall survival and hemocompatibility outcomes of HeartMate 3 (HM3) versus HeartMate II (HMII) and HeartWare (HVAD) LVADs.
- To evaluate real-world clinical performance and adverse event profiles of different LVAD generations.
Main Methods:
- A multicenter observational cohort study included 327 adult LVAD recipients.
- Survival analysis used Kaplan-Meier and Cox models; hemocompatibility-related adverse events (HRAE) were assessed using competing-risk regression.
- Hemocompatibility score (HCS) and hemolysis markers (LDH) were analyzed.
Main Results:
- HeartMate 3 (HM3) demonstrated superior long-term survival and higher HRAE-free survival compared to HMII and HVAD.
- HM3 showed significantly lower rates of pump thrombosis and ischemic stroke.
- Bleeding events were comparable across all continuous-flow devices; hemolysis markers favored HM3.
Conclusions:
- HeartMate 3 (HM3) is associated with better survival and reduced thromboembolic risk in real-world LVAD use.
- Preferential selection of HM3 is supported when device choice is feasible.
- Targeted strategies are needed to mitigate hemostatic complications in all LVADs.
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