Initial clinical experience with a novel left ventricular assist device with a magnetically levitated rotor in a multi-institutional trial

BACKGROUND: Third-generation rotary blood pumps have magnetically levitated rotors that eliminate mechanical wear over the years. Together with their potential for miniaturization, these pumps seem suitable for long-term support of patients with a wide range of body surface areas (BSA). Recently, the novel HVAD pump (Heart Ware Inc, Framingham, MA), a miniaturized centrifugal pump with a hydrodynamic, magnetically levitated rotor, became ready for clinical application. METHODS: In a multi-institutional trial in Europe and Australia, 23 patients (mean age, 47.9 +/- 12 years) in end-stage heart failure were enrolled in 5 centers. The primary end point of the bridge-to-transplant study was survival to heart transplant or survival to 180 days on the device, whichever occurred first. Follow-up data at 1 year are presented. The small size of the device allows for intrapericardial placement of the pump. RESULTS: Implant procedures were generally fast and uneventful. Mean duration of support was 167 +/- 143 days (range, 13-425 days), and mean blood flow provided by the pump was 6.1 +/- 1.1 liters/min. At the 180-day end point, 2 patients had undergone successful transplant at 157 and 175 days, 2 patients died while on the device, and 19 patients continued pump support for more than 180 days. Actuarial survival after 6 months was 91% and was 86% at the 1-year follow-up. CONCLUSIONS: The design of the HVAD pump enables a quick and less invasive implantation. The results to date demonstrate satisfactory long-term survival with excellent quality of life in this cohort of 23 patients of the initial multi-institutional Conformite Europeene (CE) mark trial. J Heart Lung Transplant 2010;29:1218-25 (C) 2010 International Society for Heart and Lung Transplantation. All rights reserved.