Short-Term Outcome after Centrifugal Continuous Flow Left Ventricular Assist Device Implantation Comparing the HeartWare, HVAD, and Abbot Heartmate III

Objectives: Centrifugal continuous flow pumps are currently the state of the art in left ventricular assist device therapy. This study was conducted to compare the results after implantation of the HVAD and the Heartmate III (HM3).

Methods: We retrospectively analyzed pre- and postoperative patient data of all 106 patients, who received a HM3 between 2014 and 2018 at our center. A total of 392 patients receiving HVAD served as controls. Patient matching was performed for age, sex, Intermacs level at the time of implant, perioperative right heart failure, and implantation strategy, that is, bridge to transplant or destination therapy.

Results: A total of 86 matched pairs could be identified. During a median follow-up of 10 months (range: 0–38 months), 26 (30.2%) and 23 (26.7%) patients died in the HVAD and HM3 groups, respectively, with a hazard ratio (HR) for mortality of 0.94 (95% confidence interval [CI]: 0.53–1.66; p = 0.835). Freedom from cerebrovascular events did not differ significantly between study groups, with a HR of 0.79 (95% CI: 0.27–1.86; p = 0.486). The risk of driveline infection was significantly higher in the HVAD (n = 55) than in the HM3 (n = 33) group (HR = 0.53; 95% CI: 0.34–0.81; p =0.003). Eight HVAD but no HM3 patients developed a pump thrombosis during follow-up (p = 0.007).

Conclusion: Performance of both currently used centrifugal LVAD systems is comparable in terms of short-term patient survival and freedom from cerebrovascular events. In our single-center experience, HM3 patients less frequently develop driveline infections and no pump thrombosis, which requires further evaluation.