Two year adverse outcomes of the magnetic levitated centrifugal continuous flow circulatory pump versus the axial continuous-flow pump for advanced heart failure

Abstract

Background: Due to advances in technology and medical devices, intra-thoracic left ventricular assisted devices such as the fully magnetically levitated centrifugal-flow pump may now prolong the life of patients with advanced heart failure. However, several concerns have been raised about pump thrombosis and durability of the device. We aimed to systematically compare the two year outcomes of magnetic levitated centrifugal continuous flow circulatory pump versus the axial continuous flow pump for advanced heart failure. Methods: Following the PRISMA guideline, online databases were searched for relevant trials based on centrifugal continuous flow circulatory pump and axial continuous flow pump in patients with advanced heart failure. The adverse clinical outcomes reported at 2 years follow-up were considered as the endpoints. This analysis was carried out by the RevMan 5.3 software whereby odds ratios (OR) and 95% confidence intervals (CI) were generated. Results: A total number of 1011 patients with advanced heart failure was included. At 2 years, pump thrombosis was not significantly different between the two groups, with OR: 0.43, 95% CI: 0.06–3.29; P = .42. However, pump replacement was significantly higher with the axial continuous-flow pump with OR: 0.36, 95% CI: 0.15–0.84; P = .02. Stroke, sepsis and bleeding events were not significantly different. In addition, outcomes such as right heart failure, cardiac arrhythmia, the need for right ventricular assisted device, respiratory failure, renal failure and hepatic dysfunction were also not significantly different. Conclusions: At a follow-up time period of 2 years, pump replacement was significantly higher with the axial continuous-flow pump in comparison to the magnetic levitated centrifugal continuous flow circulatory pump. However, no significant difference was observed with the other adverse outcomes.

Mechanical Device Malfunction of the HeartMate II Versus the HeartMate 3 Left Ventricular Assist Device: The Rotterdam Experience

“…Another review confirmed these findings with less pump replacements in the centrifugal continuous flow pumps as the HM 3 compared to the axial continuous flow pump as the HM II. 14 The findings of our study were in concordance with earlier studies with a significant HR of 0.13 for pump or outflow graft exchange and a significant HR of 0.18 for major malfunction, both in favor of the HM 3. The cumulative incidence of MDM showed no significant difference between both devices.…”

The effect of nurse-led interventions on re-admission and mortality for congestive heart failure

“…[ 29 ] The magnetic levitated centrifugal continuous flow circulatory pump and the axial continuous flow pump for advanced heart failure have also been developed. [ 30 ] However, mortality rate due to heart failure, and the rate of readmission for the same chronic disease have still not decreased. The European Society of Cardiology guidelines recommend the implementation of nurse-led heart failure programs to achieve optimal management of CHF.…”