HeartMate 3—a “Step” in the right direction

Alvarez, J.; Rao, Vivek

doi:10.21037/jtd.2017.04.39

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…28 Finally, HeartMate 3 has been described as a highly hemocompatible pump based on its design with no mechanical contact points, large gaps, and fused titanium microspheres on its blood contact surfaces which may promote the formation of a biologic barrier to further help decrease the risk of the thrombosis. 29 Based on this previous literature and our observations, we can speculate that the risk for thrombus formation could be significantly mitigated with the use of a TPScoated titanium plug. Indeed, after the complete coverage of the plug by autologous tissues, the foreign surface will not be in direct contact with the blood stream anymore.…”

Section: Discussionsupporting

confidence: 66%

“…This modification, together with new anticoagulation recommendations, led to a decline of pump exchange for thrombus from 7% (0.07 EPPY) to in 2% (0.02 EPPY) 28 . Finally, HeartMate 3 has been described as a highly hemocompatible pump based on its design with no mechanical contact points, large gaps, and fused titanium microspheres on its blood contact surfaces which may promote the formation of a biologic barrier to further help decrease the risk of the thrombosis 29 …”

Section: Discussionmentioning

confidence: 99%

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Biocompatibility of an apical ring plug for left ventricular assist device explantation: Results of a feasibility pre‐clinical study

Mariani

Hegermann

et al. 2021

Artificial Organs

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Background: Patients receiving left ventricle assist devices (LVADs) as bridge to recovery remain a minority with 1%-5% of LVADs explanted after improvement of myocardial function. Nevertheless, considering the growing population of patients supported with LVADs, an increasing demand of new explantation strategies is expected in the near future. A novel plug for LVAD explantation has been developed and its biocompatibility profile needs to be proved. This study tested the biocompatibility of this novel plug in an in vivo ovine model. Methods:Six adult Blackhead Persian female sheep received plug implantation on the cardiac apex via minimally invasive approach and were clinically observed up to 90 days. Echocardiography was performed to detect thrombus formation or further plug-related complications. After the observation period, euthanasia was performed and samples including the plug and the surrounding tissues were obtained to be analyzed with correlative light and electron microscopy. Organ necrosis, ischemia and peripheral embolism were investigated.Results: Three animals survived surgery and completed the follow-up time without experiencing clinical complications. Echocardiographic controls excluded the presence of an intracavitary thrombus in the left ventricle (LV). Autopsy confirmed no signs of local infection, LV thrombus or peripheral embolism. Light and electron microscopy revealed an intact epithelium covering a layer of connective tissue on the plug surface facing the heart lumen.Conclusions: This novel apical plug for LVAD explantation allows for endothelial and connective tissue growth on its ventricular side within 90 days from surgery. Further studies are required to fully demonstrate the biocompatibility of this apical plug and investigate the optimal anticoagulation regimen to be applied after implantation.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Biocompatibility of an apical ring plug for left ventricular assist device explantation: Results of a feasibility pre‐clinical study

Mariani

Hegermann

et al. 2021

Artificial Organs

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“…It has magnetic levitation and wide gap spaces to reduce blood damage. It does not contain any mechanical or hydrodynamic bearings [23,24].…”

Section: Tah Pulsatilementioning

confidence: 99%

The Evolution and Complications of Long-Term Mechanical Circulatory Support Devices

Sargent,

Ali,

Kanamarlapudi

2024

Hearts

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Heart failure, a common clinical syndrome caused by functional and structural abnormalities of the heart, affects 64 million people worldwide. Long-term mechanical circulatory support can offer lifesaving treatment for end-stage systolic heart failure patients. However, this treatment is not without complications. This review covers the major complications associated with implantable mechanical circulatory support devices, including strokes, pump thrombosis and gastrointestinal bleeding. These complications were assessed in patients implanted with the following devices: Novacor, HeartMate XVE, CardioWest, Jarvik 2000, HeartMate II, EVAHEART, Incor, VentrAssist, HVAD and HeartMate 3. Complication rates vary among devices and remain despite the introduction of more advanced technology, highlighting the importance of device design and flow patterns. Beyond clinical implications, the cost of complications was explored, highlighting the difference in costs and the need for equitable healthcare, especially with the expected rise in the use of mechanical circulatory support. Future directions include continued improvement through advancements in design and technology to reduce blood stagnation and mitigate high levels of shear stress. Ultimately, these alterations can reduce complications and enhance cost-effectiveness, enhancing both the survival and quality of life for patients receiving mechanical circulatory support.

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“…Bartoli et al reported that pulsatile flow preserved physiological values of myocardial energy utilization and vascular hemodynamics, such that when pulsatile unloading increased, normal LV pressures were maintained; however, under continuous flow, the pressure–volume relationship collapsed and the aortic valve remained closed [119]. To combat the complications associated with continuous-flow VADs, the HeartMate 3, a centrifugal pump, was designed to have intermittent speed reduction, to reduce stasis in the pump, as well as providing artificial pulsatility [120,121]. This device could be utilized as a cardioprotective strategy, targeting complications such as AI and improving LV systolic and diastolic function, as well as end-organ and microcirculatory perfusion.…”

Section: Mechanical Circulatory Support (Mcs)mentioning

confidence: 99%

Hurdles to Cardioprotection in the Critically Ill

Hoe

Bartnikowski

Wells

et al. 2019

IJMS

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Cardiovascular disease is the largest contributor to worldwide mortality, and the deleterious impact of heart failure (HF) is projected to grow exponentially in the future. As heart transplantation (HTx) is the only effective treatment for end-stage HF, development of mechanical circulatory support (MCS) technology has unveiled additional therapeutic options for refractory cardiac disease. Unfortunately, despite both MCS and HTx being quintessential treatments for significant cardiac impairment, associated morbidity and mortality remain high. MCS technology continues to evolve, but is associated with numerous disturbances to cardiac function (e.g., oxidative damage, arrhythmias). Following MCS intervention, HTx is frequently the destination option for survival of critically ill cardiac patients. While effective, donor hearts are scarce, thus limiting HTx to few qualifying patients, and HTx remains correlated with substantial post-HTx complications. While MCS and HTx are vital to survival of critically ill cardiac patients, cardioprotective strategies to improve outcomes from these treatments are highly desirable. Accordingly, this review summarizes the current status of MCS and HTx in the clinic, and the associated cardiac complications inherent to these treatments. Furthermore, we detail current research being undertaken to improve cardiac outcomes following MCS/HTx, and important considerations for reducing the significant morbidity and mortality associated with these necessary treatment strategies.

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HeartMate 3—a “Step” in the right direction

Cited by 10 publications

References 25 publications

Biocompatibility of an apical ring plug for left ventricular assist device explantation: Results of a feasibility pre‐clinical study

Biocompatibility of an apical ring plug for left ventricular assist device explantation: Results of a feasibility pre‐clinical study

The Evolution and Complications of Long-Term Mechanical Circulatory Support Devices

Hurdles to Cardioprotection in the Critically Ill

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