Clinical Outcomes Of HeartMate 3 LVAD Recipients Ineligible For Heart Transplantation Due To Social Factors

• Published in: Journal of cardiac failure Vol. 31; no. 1; p. 231
• Main Authors: Chia, Ricardo, Giyanani, Nisha, Kazemian, Pedram, Ice, Daniel, Ross, Ronald, Moshiyakhov, Mark, Barn, Kulpreet
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.01.2025
• ISSN: 1071-9164
• DOI: 10.1016/j.cardfail.2024.10.132

Left Ventricular Assist Devices (LVAD) have emerged as an alternative therapy for patients with end-stage heart failure, especially for those ineligible for heart transplantation. This study evaluates the clinical outcomes of HeartMate 3 LVAD recipients who were ineligible for transplantation due to social criteria, emphasizing their promising potential as a comparable alternative to heart transplantation. Methods: A single-center retrospective analysis including subjects (N=16) with end-stage heart failure deemed ineligible for heart transplantation due to social factors between 2019 to 2022. Baseline demographics, clinical, and outcome parameters including hospitalizations and complications (gastrointestinal bleeding, stroke, driveline infections, and death) following LVAD implantation. Time-to-event analysis of outcomes and survival-free event curves were performed. Patients were censored at the time of the last clinical contact or death. Results: Our cohort of subjects ineligible for heart transplantation due to social criteria who underwent HeartMate 3 LVAD implantation was predominantly male (94%), diverse (62.6% White, 31.2% Black, 6.2% Hispanic), mean age of 56.5 ± 8.8 years, and BMI of 29.0 ± 4.1, with an average follow-up time of 737.3 ± 478 days from LVAD implantation. The mean INTERMACs profile was 1.875 ± 0.96, where 50%, 12.5%, 37.5% of subjects were INTERMACs profile I, II, III respectively. Complications included GI bleeding (18.75%), stroke (12.50%), and infection (31.25%). The 1- and 4-year survival was 93.75% and 87.5% respectively. The average hospital readmission per subject over the follow up period was 8.2. For patients ineligible for heart transplantation, LVADs represent a viable, life-extending alternative, survival rates. Despite challenges, the data suggest LVAD therapy as a potentially comparable option to heart transplantation, particularly with advancements in device technology and patient management strategies.