Background
To report current outcomes in patients supported with the HeartMate 3 ventricular assist device in a multicenter learning network.
Methods
The Advanced Cardiac Therapies Improving Outcomes Network database was queried for HeartMate 3 implants between 12/2017 – 5/2022. Clinical characteristics, post-implant course, and adverse events were collected. Patients were stratified according to body surface area (<1.4 m2, 1.4-1.8 m2, and >1.8 m2) at device implantation.
Results
During the study period, 170 patients were implanted with the HeartMate 3 at participating network centers, with median age 15.3 years; 27.1% were female. Median body surface area was 1.68 m2; the smallest patient was 0.73 m2 (17.7 kg). Most (71.8%) had a diagnosis of dilated cardiomyopathy. With a median support time of 102.5 days, 61.2% underwent transplantation, 22.9% remained supported on device, 7.6% died, and 2.4% underwent device explantation for recovery; the remainder had transferred to another institution or transitioned to a different device type. The most common adverse events included major bleeding (20.8%) and driveline infection (12.9%); ischemic and hemorrhagic stroke were encountered in 6.5% and 1.2% of patients, respectively. Patients with body surface area <1.4 m2 had a higher incidence of infection, renal dysfunction, and ischemic stroke.
Conclusions
In this updated cohort of predominantly pediatric patients supported with the HeartMate 3 ventricular assist device, outcomes are excellent with <8% mortality on device. Device-related adverse events including stroke, infection, and renal dysfunction were more commonly seen in smaller patients, highlighting opportunities for improvements in care.
This ACTION study was published in The Journal of Heart and Lung Transplantation on July 5, 2023. Congratulations to the authors:
- Matthew J. O’Connor
- Muhammad Shezad
- Humera Ahmed
- Shahnawaz Amdani
- Scott R. Auerbach
- David W. Bearl
- Arene Butto
- Jonathan W. Byrnes
- Jennifer Conway
- John C. Dykes
- Lauren Glass
- Jodie Lantz
- Sabrina Law
- Michael C. Mongé
- David L.S. Morales
- John J. Parent
- David M. Peng
- Michelle S. Ploutz
- Kriti Puri
- Svetlana Shugh
- Natalie S. Shwaish
- Christina J. VanderPluym
- Sarah Wilkens
- Lydia Wright
- Matthew D. Zinn
- Angela Lorts
CITATION
Matthew J. O’Connor, et al. Expanding Use of the HeartMate 3 Ventricular Assist Device in Pediatric and Adult Patients within the Advanced Cardiac Therapies Improving Outcomes Network (ACTION). The Journal of Heart and Lung Transplantation 2023 July 5. DOI: https://doi.org/10.1016/j.healun.2023.06.015
