A Decade of Single Center HeartWareTM HVADTM Experience

Purpose Left ventricular assist device (LVAD) implantation has become a standard of care in the treatment of end-stage heart failure, either as bridge-to-transplant, bridge-to-eligibility, or destination therapy. Although caseloads are rising worldwide and the number of patients who have been supported for longer durations are increasing, no large cohort data on long-term outcomes exist. Here, we present our 10-year single center HeartWareTM HVADTM experience, describe changes in our surgical strategies, and provide long-term results. Methods From 12/2009 to 06/2019, 175 patients underwent HVADTM LVAD implantation for ischemic (34%), non-ischemic (65%) or combined (1%) cardiomyopathy. A retrospective data analysis was performed with a focus on technical aspects and follow-up data. Results Mean age at implantation was 54±13 years, 47 patients (27%) were female. The INTERMACS® levels were 1 (19%), 2 (35%), 3 (28%), 4 (15%) or 5 (2%). Fourteen percent required temporary mechanical right heart support. Seventeen percent needed readmission within the first month post HVADTM implantation. 30-day mortality was 7%. The overall survival Kaplan-Meier estimate is shown in figure 1. Forty percent underwent heart transplantation 9±6 months after LVAD implantation. Conclusion This is to date the largest single center analysis of patients undergoing HVADTM LVAD implantation. A minimally invasive approach is feasible in a high percentage where preoperative imaging and planning is essential to guide decision making. Long-term survival is substantial and rates of common complications remain moderate.