Device exchange from HeartMate II to HeartMate 3 left ventricular assist device

Abstract

The HeartMate II (HMII) left ventricular assist device can be exchanged to HeartMate 3 (HM3) to reduce the risk of device thrombosis and stroke. However, data of this procedure are still limited. We reviewed early and mid-term outcomes of 9 patients who received a HMII to HM3 exchange at our institution. The median age of the cohort was 58 years [interquartile range (IQR) 53-61], and 7 (78%) patients were men. The median duration of HMII support was 608 days (IQR 493-1116). Indications for device exchange include device thrombosis (n = 8.89%) and driveline injury (n = 1.11%). Procedures were performed through a lateral thoracotomy in all patients. The median cardiopulmonary bypass time was 117 min (IQR 97-133). In-hospital mortality was 0%. One patient required repositioning of the HM3 pump through full sternotomy due to inflow malposition. During 486 days (IQR 235-712) of follow-up, 3 patients (33%) developed late HMII pump pocket infection after discharge. Five patients had a successful heart transplant and 1 patient died due to unknown reason. HMII to HM3 exchange can be performed via lateral thoracotomy. However, there is a risk of inflow malposition and previous pump pocket infection.