Early Outcomes After Heart Transplantation in Recipients Bridged With a HeartMate 3 Device

This study examines early outcomes of transplant recipients after HM3 in comparison with recipients bridged with the HeartMate 2 (HM2; Abbott Laboratories) and HeartWare Ventricular Assist System (HVAD; Medtronic, Minneapolis, MN) devices.MethodsUsing the Organ Procurement and Transplantation Network database, we identified all adult patients who were slated for bridge-to-transplantation with a continuous-flow left ventricular assist devices (HM2, HVAD, or HM3) between April 1, 2015 and January 31, 2018. The primary endpoint was all-cause mortality 6 months after transplantation. The independent influence of the bridging device on outcomes was determined using Cox proportional hazard models.ResultsPatients (N = 1,978) were successfully bridged to transplantation with the HM2 (n = 881), HVAD (n = 920), or HM3 (n = 177) device. Six-month mortality rates were similar across these devices (HM2, 5.9%; HVAD, 7.7%; HM3, 4.7%; log-rank p = 0.30). On average HM2 patients were on a left ventricular assist device for 2 months longer (p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Left ventricular assist device (LVAD) implantation continues to occur at an exceedingly high rate due to the donor and supply mismatch when it comes to heart transplantation. LVADs however do not come without risk and have high rates of significant bleeding, stroke, pump thrombosis and infection. Most of the clinical and research efforts thus far have been focused on LVAD insertion with the goal of destination therapy or as a bridge to transplant. The goal of bridge to recovery has often been underestimated despite multiple studies showing reverse remodeling of the myocardium.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 361 Source Type: research
Abstract BACKGROUND: Thrombocytopenia is a common disorder after heart or lung transplantation. Platelet transfusion is often required to maintain haemostasis but represents a specific cause of morbidity and mortality in this setting including alloimmunisation and graft rejection. STUDY DESIGN AND METHODS: As part of a health-care quality improvement project, in a single-centre before-after pilot study, the relevance of a platelet transfusion saving strategy based on romiplostim administration after transplantation was assessed in patients with platelet count
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Authors: Eisen HJ Abstract Congestive heart failure is a major cause of morbidity and mortality as well as a major health care cost in the developed world. Despite the introduction of highly effective heart failure medical therapies and simple devices such as cardiac resynchronization therapy that reduce mortality, improve cardiac function and quality of life, there remains a large number of patients who do not respond to these therapies or whose heart failure progresses despite optimal therapy. For these patients, cardiac transplantation is an option but is limited by donor availability as well as co-morbidities w...
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
We describe our experience of bivalirudin use, a newer direct thrombin inhibitor, in an infant who was supported with Berlin Heart EXCOR VAD (Berlin VAD) as bridge to transplant for 122 days without complications and without need for pump exchange. An 11-month-old girl with dilated cardiomyopathy with acute heart failure was awaiting cardiac transplant. Lack of improvement despite maximizing medical therapy and anticipating a prolonged waitlist time, she was supported with Berlin LVAD as a bridge to transplant. Anticoagulation with bivalirudin was started and titrated with a goal partial thromboplastin time of 60-90...
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
We present the case of a HM-3 controller malfunction, resembling pump thrombosis based on acute changes to pump parameters and abnormal LVAD log file analysis.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: CASE ANECDOTES, COMMENTS AND OPINIONS Source Type: research
Key difference exist between adult and pediatric Ventricular Assist Device (VAD) care. For many adult patients, VADs are commonly implanted as destination therapy in contrast to pediatric patients who more often receive VAD therapy as a bridge to transplant. Adult patients/families may be better prepared for the anticipated and enivadable complications that occur at the end of destination therapy, but receive benefit from VAD therapy for both prolonged quantity and quality of life. Despite the success of VAD as a bridge to heart transplantation in children, adverse and debilitating events, including stroke, thrombosis, inf...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Letter to the Editor Source Type: research
These findings bring new insight into the role of endothelial cells in the pathogenesis of CTEPH, highlighting the role of endothelial ICAM-1. We provide the first in vitro demonstration that ECs isolated from organized thrombus of CTEPH patients exhibit dysfunctional phenotype. Furthermore, our findings demonstrate that ICAM-1 overproduction by ECs induces a hyperproliferative and apoptosis-resistant EC phenotype via an autocrine loop. The KE and EE genotypes are more frequent in patients with CTEPH than controls but are not associated with disease severity, suggesting that ICAM-1 E469K polymorphism may play a role in the...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
Conclusions: Real-time telemonitoring of LVAD pump flow, motor speed and power consumption is a promising tool in the follow-up of LVAD recipients. Trending pump flow over hours or days can assist in the early detection of complications, especially flow reductions due to hypovolemia and LVAD thrombosis. Further studies are warranted to delineate the impact of remote monitoring on patients' prognosis. PMID: 31183165 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
The continuous-flow centrifugal HeartMate 3 left ventricular assist device (Abbott, Abbott Park, IL) is associated with a low risk of de-novo pump thrombosis. In a previous study (the Minimal AnticoaGulation EvaluatioN To aUgment heMocompatibility [MAGENTUM-1] study, ClinicalTrials.gov No. NCT03078374; funded by Abbott and the Ministry of Health, Czech Republic), we reported results of a prospective, observational, pilot trial of reduced intensity warfarin (target international normalized ratio [INR] range 1.5 –1.9) with aspirin in 15 patients implanted with a HeartMate 3 pump and enrolled after 6 weeks.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: RESEARCH CORRESPONDENCE Source Type: research
This study provides further insight into our understanding of the pathogenesis of LVAD thrombosis, addressing SMPA as a relevant key factor associated with thrombotic complications. With the PAS assay, we have identified a reliable biomarker to promote tailored pharmacological therapy for the prevention of thromboembolic events in patients with LVADs.
Source: ASAIO Journal - Category: Medical Devices Tags: Case Reports Source Type: research
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