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HeartMate II left ventricular assist device; early European experience

^a Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
^b Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
^c Department of Cardiothoracic Surgery, Heart Lung Center, University Medical Center Utrecht, Utrecht, Netherlands
^d Departments of Cardiovascular Surgery and Anesthesia, University Hospital Linkoping, Linkoping, Sweden
^e Department of Thoracic and Cardiac Surgery, Rouen University, Rouen, France
^f 3rd Cardiology Department, University Of Athens, Athens, Greece
^g Azienda Ospedaliera San Camillo, Rome, Italy
^h Department of Cardiovascular Surgery, University Hospital Freiburg, Freiburg, Germany
ⁱ University Clinic and Polyclinic for Cardiac und Thoracic Surgery, University Hospital Halle, Halle, Germany
^j Heart and Lung Division, Section of Cardiothoracic Surgery, University Hospital Lund, Lund, Sweden
^k Department of Cardiac and Thoracic Surgery, Heart Centre Augsburg-Schwaben, Augsburg, Germany
^l Thoracic and Cardiovascular Surgery, GH Pitié-Salpêtrière, Paris, France

Received 20 November 2007; received in revised form 9 May 2008; accepted 9 May 2008.

^_* Corresponding author. Address: Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Tel.: +49 511 532 4179; fax: +49 511 532 8452. (Email: strueber.martin{at}mh-hannover.de).

Objective: The novel axial flow left ventricular assist device HeartMate II was introduced into clinical practice in Europe as part of the pilot study and after CE approval in November 2005. In order to get an overview of the use and performance of the device in Europe a group of investigators was founded to compare the initial results. Methods: In a retrospective analysis of the first 101 consecutive cases in Europe, data were collected with regard to postoperative outcome and severe adverse events and anticoagulation protocols. Results were stratified by intention to treat as a bridge to transplant or as chronic support therapy in heart failure (destination therapy). Results: In 70% of patients, the HeartMate II was intended as a bridge to transplant therapy, in 30%, it was used as a destination therapy device. The perioperative mortality post implant was 20% in the bridge to transplant patients and 7% in the destination therapy arm. However, after 1 year a comparable survival was observed in both groups (69% destination therapy, 63% bridge to transplant). Main causes of death were multiple organ failure (n = 12) and cerebrovascular accidents (n = 5). All, but one cerebrovascular accident occurred in the first 9 days after surgery. Only one other death was reported thereafter and there was no mechanical failure of the device. Conclusions: Even in the early experience the HeartMate II was used as a chronic support device in a substantial number of patients in Europe. Although the total experience is still limited, the incidence of cerebrovascular accidents is very low and the survival beyond the perioperative period is excellent.

Key Words: LVAD • HeartMate II • Adverse events

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				M. Strueber Editorial comment: Indication for mechanical circulatory support in high urgent heart transplant candidates Eur. J. Cardiothorac. Surg., December 1, 2008; 34(6): 1134 - 1135. [Full Text] [PDF]