Long-term evaluation of a fully magnetically levitated circulatory support device for advanced heart failuretwo-year results from the HeartMate 3CE Mark Study

AimThis study aimed to assess safety and outcomes of patients, 2years after implantation with the HeartMate 3 Left Ventricular Assist System. Methods and resultsThis study included 50 adults with New York Heart Association (NYHA) class IIIB or IV symptoms or American College of Cardiology/American Heart Association stage D heart failure with an ejection fraction 25% and a cardiac index 2.2L/min/m(2) without inotropes, or inotrope-dependent with optimal medical management, or listed for heart transplant. The median duration of left ventricular assist device support was 694days (range: 19-833days). At baseline, cardiac index was 1.80.5L/min/m(2), 58% of patients were receiving inotropes, and 92% were INTERMACS profiles 2-4. At 2years, Kaplan-Meier survival was 746%, 5 (10%) patients were transplanted, and 32 patients (64%) remain with support. Adverse event rates include bleeding requiring surgery (16%), gastrointestinal bleeding (20%), driveline infection (24%), ischaemic stroke (16%), haemorrhagic stroke (8%), right heart failure (14%), and outflow graft thrombosis (2%). Notably, no haemolysis, pump thrombosis, or pump malfunction events occurred. At 2years, 47% of patients remained in NYHA class I and 41% in NYHA class II (P<0.0001). From baseline to 2years, the mean six-minute walk distance increased from 239m to 347m (P<0.0001), and the mean EQ-5D quality of life score improved from 48.2 to 70.6 (P<0.0001). ConclusionsTwo years post-HeartMate 3 implantation, results show expected and acceptable survival, enhanced haemocompatibility, improved patient functional status and quality of life. This corroborates the success of HeartMate 3 since its first-in-man implantation case in Germany. : NCT02170363.