AUTHOR=Francica Alessandra , Loforte Antonio , Attisani Matteo , Maiani Massimo , Iacovoni Attilio , Nisi Teodora , Comisso Marina , Terzi Amedeo , De Bonis Michele , Vendramin Igor , Boffini Massimo , Musumeci Francesco , Luciani Giovanni Battista , Rinaldi Mauro , Pacini Davide , Onorati Francesco 

TITLE=Five-Year Outcome After Continuous Flow LVAD With Full-Magnetic (HeartMate 3) Versus Hybrid Levitation System (HeartWare): A Propensity-Score Matched Study From an All-Comers Multicentre Registry

JOURNAL=Transplant International

VOLUME=Volume 36 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11675

DOI=10.3389/ti.2023.11675

ISSN=1432-2277

ABSTRACT=Despite the withdrawal of the HeartWare Ventricular Assist Device (HVAD), hundreds of patients are still supported with this continuous-flow pump, and the long-term management of these patients is still under debate. This study aims to analyse five-year survival and freedom from major adverse events in patients supported by HVAD and HeartMate3 (HM3). From 2010 to 2022, the MIRAMACS Italian Registry enrolled all-comer patients receiving a LVAD support at seven Cardiac Surgery Centres. Out of 447 LVAD implantation, 214 (47.9%) received HM3 and 233 (52.1%) received HVAD. Cox-regression analysis adjusted for major confounders showed an increased risk for mortality (HR 1.5 [1.2-1.9]; p=0.031), for both ischemic stroke (HR 2.08 [1.06-4.08]; p=.033) and haemorrhagic stroke ; p=.005), and for pump thrombosis ; p<.001) in HVAD patients. The propensity-score matching analysis (130 pairs of HVAD vs HM3) confirmed a significantly lower 5-year survival (81.25 vs 64.1%; p .02) (Figure 1B), freedom from haemorrhagic stroke (90.5% vs 70.1%; p <.001) and from pump thrombosis (98.5% vs 74.7%; p<.001) in HVAD cohort. Although similar perioperative outcome, patients implanted with HVAD developed a higher risk for mortality, haemorrhagic stroke and thrombosis during 5-year of followup compared to HM3 patients.