Short-Term Outcomes of Magnetically Levitated Left Ventricular Assist Device in Advanced Heart Failure　― The Japanese Cohort ―

Abstract

LVADs, many patients still experience LVAD-specific complications such as stroke, infections (including driveline exit site or the LVAD pump itself), and device failure. 6-8 HeartMate 3 (HM3; Abbott Laboratories, Chicago, IL, USA) which is a fully magnetically levitated centrifugalflow pump, was developed as a next-generation LVAD. Several international trials have already demonstrated its superiority over previous axial-flow pumps for event-free survival. 9,10The clinical outcomes of LVADs with axial-flow pumps in Japanese cohorts were superior to those in other countries, 11,12 but the clinical results of new centrifugal LVAD remain to be evaluated. Herein, we demonstrate the short-term outcomes of HM3 implantation in comparison L eft ventricular assist devices (LVADs) provide improvements in survival and quality of life for patients with advanced heart failure (HF). 1,2 In the past decade, the indication for LVAD implantation has expanded not only as a bridge to transplantation (BTT) but also as destination therapy (DT) for patients ineligible for heart transplantation in the USA and Europe, and the clinical results in both BTT and DT patients have improved. [3][4][5] With technological advances, LVADs with continuous axial-flow pumps have been developed, making them smaller, with fewer moving parts (less biological reaction), and greater durability compared with the older models. 1,2 However, considering the prolonged support time of

Mechanical circulatory support for adults in Japan: A 10‐year perspective

“…36 A recent multi-center study conducted in Japan demonstrated a significantly reduced stroke event in relatively small patients with a HeartMate 3 as compared with a HeartMate II. 37 Thus, low pump flow may not be a significant risk factor for strokes in patients with a HeartMate 3, which features a fully magnetically levitated centrifugal-flow pump, though further study is needed. Another feature of Japanese patients is prolonged support duration before heart transplantation because of the severe donor shortage.…”

“…Therefore, preoperative evaluations of the chest wall and left ventricular apex by 3D CT scanning is important especially for small patients to prevent suboptimal positioning of the inflow cannula 36 . A recent multi‐center study conducted in Japan demonstrated a significantly reduced stroke event in relatively small patients with a HeartMate 3 as compared with a HeartMate II 37 . Thus, low pump flow may not be a significant risk factor for strokes in patients with a HeartMate 3, which features a fully magnetically levitated centrifugal‐flow pump, though further study is needed.…”