Ten-year outcome after HeartMate 3 left ventricular assist device implantation

The HeartMate 3 left ventricular assist device (HM3, Abbott, U.S.A.) (LVAD) was first implanted in humans in 2014 at Hannover Medical School, Germany. This report presents the most extended single-center follow-up, ten years after HM3 implantation, focusing on survival rates and adverse events.

We analyzed heart failure patients who received LVAD implantations with HM3 at our institution in 2014. The primary endpoint was 10-year survival. The secondary endpoint included evaluating adverse events. Follow-up for survival was censored in case of heart transplantation (HTx).

A total of eight HM3 patients were included in the study. We observed a total of 18,744 days-on-device (approx. 39 patient-years). The mean duration of device support was 2343 days (6.4 years). Ten years after LVAD implantation, the survival rate was 62.5% (5/8). Three patients underwent HTx (postoperative day (POD) 101, 646, 1917), three patients died, and two patients are on-going on device. The cause of death was sepsis in two patients (POD 2974 and 3018), while one patient died due to COVID-19-associated respiratory failure (POD 2642). No pump thrombosis, stroke, or technical malfunctions were observed. Outflow graft compression syndrome required surgical revision in 50% of patients. Six patients (75%) experienced driveline infections.

The HM3 has shown excellent long-term outcomes ten years after implantation, with no technical malfunctions and a low incidence of hemocompatibility-related adverse events. This study highlights the strong performance of assist devices and excellent outcomes for heart failure patients, especially when LVADs are timely and appropriately used in selected patients.