Ten-year outcome after HeartMate 3 left ventricular assist device implantation

BACKGROUND: The HeartMate 3 left ventricular assist device (HM3, Abbott, U.S.A.) (LVAD) was first implanted in humans in 2014 at Hannover Medical School, Germany. This report presents the most extended single-center follow-up, ten years after HM3 implantation, focusing on survival rates and adverse events. METHODS: We analyzed heart failure patients who received LVAD implantations with HM3 at our institution in 2014. The primary endpoint was 10-year survival. The secondary endpoint included evaluating adverse events. Follow-up for survival was censored in case of heart transplantation (HTx). RESULTS: A total of eight HM3 patients were included in the study. We observed a total of 18,744 days-on-device (approx. 39 patient-years). The mean duration of device support was 2343 days (6.4 years). Ten years after LVAD implantation, the survival rate was 62.5% (5/8). Three patients underwent HTx (postoperative day (POD) 101, 646, 1917), three patients died, and two patients are on-going on device. The cause of death was sepsis in two patients (POD 2974 and 3018), while one patient died due to COVID-19-associated respiratory failure (POD 2642). No pump thrombosis, stroke, or technical malfunctions were observed. Outflow graft compression syndrome required surgical revision in 50% of patients. Six patients (75%) experienced driveline infections. CONCLUSIONS: The HM3 has shown excellent long-term outcomes ten years after implantation, with no technical malfunctions and a low incidence of hemocompatibility-related adverse events. This study highlights the strong performance of assist devices and excellent outcomes for heart failure patients, especially when LVADs are timely and appropriately used in selected patients.