Single-Center Experience with the HeartMate 3 Assist Device in Pediatric Patients with Cardiomyopathy

Background and Objectives: The use of the HeartMate 3 (HM3) ventricular assist device (VAD) as a bridge to transplant is rising notably in pediatric patients with end-stage heart disease. This study reports a single-centre experience with the HM3 device in pediatric patients. Materials and Methods: We conducted a retrospective clinical data review (including procedural, perioperative and follow-up parameters) of pediatric patients (n = 5, aged 10-16 years) supported with HM3 VAD at our institution between January 2022 and October 2025. Results: During this period, five pediatric patients (median age of 13 years [range 10-16, IQR 10-14.5]; median weight of 41.5 kg [24-75 IQR 32-62]) underwent HM 3 implantation. The Pedimacs profiles ranged from 1 to 2. Two patients with Pedimacs profile 1 received a temporary left ventricular assist device preoperatively for hemodynamic stabilization. The median intensive care unit stay was 47 days (range 21-54, IQR 28-50.5). Right ventricular dysfunction occurred in four patients and was managed conservatively in three, while one required intraoperative implantation of a temporary CentriMag right ventricular assist device. Two patients remain on device support, while three patients were successfully bridged to heart transplantation. No mortality was observed, and none of the patients experienced pump-related complications. Conclusions: The use of the HeartMate 3 is a safe and effective treatment strategy for successful bridging to heart transplantation. Right ventricular dysfunction is a common and clinically significant complication, but it can be effectively managed with appropriate measures.