In:
European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), Vol. 56, No. 6 ( 2019-12-01), p. 1054-1061
Abstract:
OBJECTIVES In this study, we aimed to determine the comparative outcomes of patients supported with continuous-flow left ventricular assist devices (LVADs): HeartMate 2 (HM2), HeartWare (HW) and HeartMate 3 (HM3) in a real-world setting. METHODS The study was an investigator-initiated comparative retrospective analysis of patients who underwent continuous-flow LVAD implantation at our institution between 2008 and 2017. The follow-up duration was 18 months after implantation. RESULTS The study included 105 continuous-flow LVAD-supported patients of whom 51% (n = 54), 24% (25) and 25% (26) underwent implantation of HM2, HW and HM3, respectively. During follow-up, patients who were supported with HM3 versus either HM2 or HW LVADs demonstrated a lower risk of stroke (0% vs 26%, P 〈 0.001 and 0% vs 40%, P 〈 0.001, respectively) and lower rates of thrombosis (0% vs 31%, P 〈 0.001 and 0% vs 12%, P 〈 0.001, respectively), findings that were consistent with their calculated haemocompatibility scores (cumulative score 5, 89 and 56 for HM3, HM2 and HW, respectively, P 〈 0.001). Moreover, patients supported with HM3 versus HW had fewer unplanned hospitalizations [median 1 (25th–75th interquartile range 0–2) vs 3 (interquartile range 2–4), P = 0.012]. Importantly, survival free from stroke or device exchange was higher in patients supported with HM3 compared with either the HM2 or the HW LVADs [hazard ratio (HR) 2.77, confidence interval (CI) 1.13–6.78; P = 0.026 and HR 2.70, CI 1.01–7.20; P = 0.047, respectively] . CONCLUSIONS HM3 device currently presents better prognostic and adverse events profiles when compared with the HM2 or the HW LVADs. A larger-scale head-to-head comparison between the devices is warranted in order to confirm our findings.
Type of Medium:
Online Resource
ISSN:
1010-7940
,
1873-734X
DOI:
10.1093/ejcts/ezz268
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2019
detail.hit.zdb_id:
1500330-9
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