Karaca Sedat, Kahraman Ümit, Tuncer Osman Nuri, Erdinli Dilek, Engin Çağatay, Yağdı Tahir, Atay Yüksel, Özbaran Mustafa
Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):064-64. doi: 10.5606/tgkdc.dergisi.2024.msb-38. eCollection 2024 Nov.
This study aimed to compare the outcomes of HVAD (Heartware Ventricular Assist Device) and HeartMate 3 (HM3) used as a bridge to transplantation in end-stage heart failure.
This retrospective study included 34 patients under 18 years of age who underwent HVAD (n=22; 13 females, 9 males; mean age: 12.7 years) or HM3 (n=12; 8 females, 4 males; mean age: 12.9 years) implantation at a single center between 2012 and 2024. Kaplan-Meier analysis was conducted to assess survival.
There were no significant differences between the HVAD and HM3 groups in terms of age (p=0.78), weight (44.3 37.7 kg, p=0.25), height (155.6 151.5 cm, p= 0.49), body surface area (1.92 1.76 m, p=0.29), and sex (p=0.66). The mean cardiopulmonary bypass time was higher in the HM3 group (59 78.5 min, p<0.05). The average support duration was 899 days. Postoperative complications showed no statistically significant differences in infection (n=5 n=2, p=0.68) and cerebrovascular accidents (n=4 n=0, p=0.11) between the HVAD and HM3 groups, while pump thrombosis showed a statistically significant difference (n=8 n=0, p<0.05). During the five-year follow-up, nine patients underwent heart transplantation, 17 patients were on device followup, and eight patients died (seven patients with HVAD and 1 patient with HM3; p=0.12).
HeartMate 3 represents an outstanding option for pediatric patients due to its low complication rates and high survival rates. Further research is needed to develop an intracorporeal device suitable for implantation in neonates and infants.
本研究旨在比较Heartware心室辅助装置（HVAD）和HeartMate 3（HM3）作为终末期心力衰竭患者移植桥梁的效果。
这项回顾性研究纳入了2012年至2024年间在单一中心接受HVAD植入（n = 22；13名女性，9名男性；平均年龄：12.7岁）或HM3植入（n = 12；8名女性，4名男性；平均年龄：12.9岁）的34例18岁以下患者。采用Kaplan-Meier分析评估生存率。
HVAD组和HM3组在年龄（p = 0.78）、体重（44.3±37.7 kg，p = 0.25）、身高（155.6±151.5 cm，p = 0.49）、体表面积（1.92±1.76 m²，p = 0.29）和性别（p = 0.66）方面无显著差异。HM3组的平均体外循环时间更长（59±78.5分钟，p<0.05）。平均支持时间为899天。HVAD组和HM3组术后并发症在感染（n = 5 vs n = 2，p = 0.68）和脑血管意外（n = 4 vs n = 0，p = 0.11）方面无统计学显著差异，而泵血栓形成有统计学显著差异（n = 8 vs n = 0，p<0.05）。在五年随访期间，9例患者接受了心脏移植，17例患者接受装置随访，8例患者死亡（7例HVAD患者和1例HM3患者；p = 0.12）。
由于并发症发生率低和生存率高，HeartMate 3是儿科患者的一个优秀选择。需要进一步研究开发适合新生儿和婴儿植入的体内装置。
