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HeartMate 3™ experience: a single-center retrospective study
Session:
Comunicações Orais - Sessão 08 - Insuficiência cardíaca: da clínica aos dispositivos
Speaker:
Christopher Strong
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Christopher Strong; Carlos Aguiar; Sérgio Maltês; Bruno Rocha; Catarina Brízido; Márcio Madeira; Tiago Nolasco; Marta Marques; Miguel Sousa Uva; Miguel Abecassis; José Pedro Neves
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction and aims:</strong> The prevalence of advanced heart failure is increasing, thus creating a supply-demand mismatch limiting access to its gold standard therapy - heart transplantation (HT). Long-term left ventricular assist devices (LT-LVAD) – HeartMate 3 (HM3), are nowadays an established therapy to fill the gap left by the shortage of donors. The first HM3 implant in Portugal was in 2017, and since then 34 LT-LVAD surgeries have been performed across the country. We aimed to describe our single-center experience in HM3 implantation.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results:</strong> During the 6-year period (2017-2023), 18 patients underwent HM3 implantation (median days on LT-LVAD support 415 [248-670]), with a progressive annual increase in the number of implantations/year (see figure 1). 3 additional patients who had the surgery abroad were followed at our center. Mean age 5512 years, 81% males (n=21). 10 patients had the device placed as bridge to HT, 7 as bridge to candidacy to HT (most for severe pulmonary hypertension) and 4 as destination therapy. Most patients were on INTERMACS profiles 2 or 3 (n=14) at the time of LT-LVAD surgery. One patient suffered severe right heart failure early after surgery with need for short-term right VAD. The most frequent complication after HM3 implantation has been VAD-specific infection (percutaneous driveline infections) - 8 episodes with need for hospital admission, followed by gastrointestinal bleeding (4 episodes). Intracranial bleeding occurred in 3 patients, 2 with good functional outcome. There were no thrombotic complications among our cohort. During follow-up, 9 patients subsequently underwent a heart transplant (median 581 [375-712] days after HM3 surgery). 4 patients died while on HM3 support, 2 of them from complications related to VAD-specific infections. </span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusions:</strong> HM3 is increasingly being implanted in Portugal, serving as a potentially life-saving therapy in those that cannot wait or have a reversible contraindication for HT, or that are not eligible for HT. Despite the advances in LT-LVAD technology, the burden of adverse events remains significant, not that different, however, from those experienced after HT. Our results reflect those reported in recent literature. </span></span></span></p>
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