The Abbott HeartMate 3™ Left Ventricular Assist System

2019 ◽  
pp. 78-83
Author(s):  
Kevin Bourque ◽  
John B. O’Connell
Keyword(s):  
Magnetic Levitation ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Left Ventricular Assist System ◽  
Ventricular Assist ◽  
System P ◽  
Pump Thrombosis ◽  
Left Ventricular Assist ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Mechanical circulatory support devices are increasingly used to treat chronic, advanced heart failure. In the Abbott HeartMate 3™ left ventricular assist system (HM3), a new magnetic levitation pump improves hemocompatibility and thus addresses the prominent morbidities associated with these devices, such as pump thrombosis, stroke, and bleeding. In the multicenter MOMENTUM 3 clinical trial of 366 patients, the primary endpoint—survival without disabling stroke or pump replacement—was 77.9% in the HM3 group (n = 190) and 56.4% in the HeartMate II™ Left Ventricular Assist System group (HMII; n = 176; P <0.001). Suspected or confirmed pump thrombosis occurred in two patients (1.1%) in the HM3 group and in 27 patients (15.7%) in the HMII group (P <0.001). Also at 2 years, 22 strokes occurred in 19 patients (10.1%) with the HM3 and 43 strokes occurred in 33 patients (19.2%) with the HMII (P = 0.02), indicating that the HM3 provides important improvements in care.

Development of Mechanical Circulatory Support Devices: 55 Years and Counting

2021 ◽  
Vol 32 (4) ◽  
pp. 424-433
Author(s):  
Emalie Petersen
Keyword(s):  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Heart failure is a leading cause of morbidity and mortality in the United States. Treatment of this condition increasingly involves mechanical circulatory support devices. Even with optimal medical therapy and use of simple cardiac devices, heart failure often leads to reduced quality of life and a shortened life span, prompting exploration of more advanced treatment approaches. Left ventricular assist devices constitute an effective alternative to cardiac transplantation. These devices are not without complications, however, and their use requires careful cooperative management by the patient’s cardiology team and primary care provider. Left ventricular assist devices have undergone many technological advancements since they were first introduced, and they will continue to evolve. This article reviews the history of different types of left ventricular assist devices, appropriate patient selection, and common complications in order to increase health professionals’ familiarity with these treatment options.

The HeartMate II™ Continuous-Flow Left Ventricular Assist System

2019 ◽  
pp. 70-77
Author(s):  
David J. Farrar
Keyword(s):  
Left Ventricular ◽  
Circulatory Support ◽  
Left Ventricular Assist System ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Pump Speed ◽  
System P ◽  
Left Ventricular Assist ◽  
Mechanical Circulatory Support Device ◽  
End Stage

The HeartMate II™ Left Ventricular Assist System has been implanted in more than 26,000 patients and is the most widely used and studied durable mechanical circulatory support device in patients with advanced heart failure. The device is intended for use as bridge to transplantation in candidates at risk of imminent death from non-reversible left ventricular (LV) failure and for destination therapy for use in patients with end-stage LV failure. This chapter describes each component of the system, the mechanisms of the pump itself, the physiology of blood flow under different pump speeds and pressure gradients, and ways to prevent pump thrombus. In addition, the functions and interface of the System Controller and System Monitor are detailed, including the settings displayed on the monitor and the type of alarms provided, as well as their appearance on the interface. The chapter closes with a discussion of how a ramped-speed study using echocardiography and hemodynamic assessment can identify the pump speed that provides the desired level of cardiac support for each patient.

scholarly journals Updates on management of advanced heart failure

2017 ◽  
Vol 5 (20) ◽  
pp. 12
Author(s):  
Hatice Duygu Bas ◽  
Kazim Baser ◽  
Nandini Nair
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Circulatory Support ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Patients With Heart Failure ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices ◽  
Recommended Therapy

Advanced heart failure defines a subset of patients with heart failure with reduced ejectionfraction having severe symptoms despite usual recommended therapy. These patients requirefrequent hospitalizations and specialized interventions, such as cardiac transplantation,implantation of mechanical circulatory support devices, continuous intravenous inotropictherapy to palliate symptoms, or continued terminal care. This review summarizes themanagement of advanced heart failure with updates in medical therapy and recent advancesin surgical therapy, particularly left ventricular assist device therapy.

Novacor Left Ventricular Assist System

1991 ◽  
Vol 2 (3) ◽  
pp. 575-586 ◽  
Author(s):  
Julie A. Shinn
Keyword(s):  
Clinical Investigation ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Patient Support ◽  
Left Ventricular Assist System ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Upper Abdominal ◽  
Abdominal Quadrant

Clinical investigation of the Novacor ventricular assist system has been ongoing since 1984. Major successes have been achieved using the device as a bridge to heart transplant. This system uses an electrically driven, pulsatile pump implanted in the left upper abdominal quadrant. The system has demonstrated the ability to provide long-term patient support, a feature that allows patients to become mobile and active once recovered from their initial heart failure. By the time of transplant, nutrition is restored, activity tolerance is improved, and most patients require no inotropic support. The system allows patients to recover from cardiogenic shock by providing total systemic circulatory support

scholarly journals Incidence of Pump Thrombosis in HeartMate II during Destination Therapy

2016 ◽  
Author(s):  
Rohan Samson ◽  
Abhishek Jaiswal ◽  
Frank Smart ◽  
Thierry H. LeJemtel
Keyword(s):  
Left Ventricular ◽  
Circulatory Support ◽  
Destination Therapy ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Pump Thrombosis ◽  
Wide Range ◽  
Left Ventricular Assist ◽  
Low Incidence

Pump thrombosis occurs during destination therapy (DT) with HeartMate II, a continuous blood flow left ventricular assist device (St Jude, Pleasanton, CA, USA). With adherence to stringent post-operative and long-term anticoagulation a low incidence of pump thrombosis was initially reported during DT. The increased PT incidence during DT that was reported in early 2013 was attributed to lenient anticoagulation. A wide range of pump thrombosis incidence during DT is being reported since the return to stringent post-operative and long-term anticoagulation. We searched PubMed from January 2008 to February 2016 for reports of pump thrombosis during mechanical circulatory support with HeartMate II and focus on the incidence rate of pump thrombosis from DT approval by the Food and Drug Administration to present. Pump thrombosis which may have been initially underestimated continues to complicate DT with HeartMate II despite stringent post-operative and long-term anticoagulation.

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