Identifying patients at risk: multi‐centre comparison of HeartMate 3 and HeartWare left ventricular assist devices

Aims Since the withdrawal of HeartWare (HVAD) from the global market, there is an ongoing discussion if and which patients require prophylactically exchange for a HeartMate 3 (HM3). Therefore, it is important to study outcome differences between HVAD and HM3 patients. Because centres differ in patie...

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Published in:ESC Heart Failure 2023-06, Vol.10 (3), p.1656-1665
Main Authors: Numan, Lieke, Zimpfer, Daniel, Zadok, Osnat Itzhaki Ben, Aarts, Emmeke, Morshuis, Michiel, Guenther, Sabina P.W., Riebandt, Julia, Wiedemann, Dominik, Ramjankhan, Faiz Z., Oppelaar, Anne‐Marie, Ben‐Gal, Tuvia, Ben‐Avraham, Binyamin, Asselbergs, Folkert W., Schramm, Rene, Van Laake, Linda W.
Format: Article
Language:English
Subjects:
Body mass index
Brain Ischemia - complications
Cardiomyopathy
Centrifugal continuous flow pump
Diabetes
End‐stage heart failure
Female
Heart failure
Heart Failure - etiology
Heart Failure - surgery
Heart-Assist Devices - adverse effects
Humans
Ischemia
Left ventricular assist device
LVAD
Male
Mechanical circulatory support
Middle Aged
Missing data
Original
Patients
Stroke
Stroke - epidemiology
Thrombosis
Thrombosis - epidemiology
Thrombosis - etiology
Transplants & implants
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Summary:Aims Since the withdrawal of HeartWare (HVAD) from the global market, there is an ongoing discussion if and which patients require prophylactically exchange for a HeartMate 3 (HM3). Therefore, it is important to study outcome differences between HVAD and HM3 patients. Because centres differ in patient selection and standard of care, we performed a propensity score (PS)‐based study including centres that implanted both devices and aimed to identify which HVAD patients are at highest risk. Methods and results We performed an international multi‐centre study (n = 1021) including centres that implanted HVAD and HM3. PS‐matching was performed using clinical variables and the implanting centre. Survival and complications were compared. As a sensitivity analysis, PS‐adjusted Cox regression was performed. Landmark analysis with conditional survival >2 years was conducted to evaluate long‐term survival differences. To identify which HVAD patients may benefit from a HM3 upgrade, Cox regression using pre‐operative variables and their interaction with device type was performed. Survival was significantly better for HM3 patients (P 
ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.14308