Salewski Christoph, Sandoval Boburg Rodrigo, Marinos Spiros, Doll Isabelle, Schlensak Christian, Nemeth Attila, Radwan Medhat
Department of Thoracic and Cardiovascular Surgery, Tübingen University Hospital, 72076 Tübingen, Germany.
Biomedicines. 2025 Jul 22;13(8):1795. doi: 10.3390/biomedicines13081795.
In advanced heart failure patients implanted with a fully magnetically levitated HeartMate 3 (HM3) Abbott left ventricular assist device (LVAD), it is unknown how the role of the LVAD outpatient clinic may affect the long-term survival after hospital discharge. Our objective is to share our standardized protocol for outpatient care, to describe the role of the LVAD outpatient clinic in postoperative long-term care after LVAD implantation, and to report survival.
We retrospectively reviewed all patients implanted with HM3 LVAD in our institute between September 2015 and January 2025. Patients who received HeartWare Ventricular Assist Device (HVAD) and HeartMate 2 LVAD devices were excluded from our study, to ensure a homogenous cohort focusing on the latest and the only currently used LVAD device generation. We included a total of 48 patients. After LVAD patients are discharged from our center, they are followed in our outpatient clinic in 3-month intervals. During visits, bloodwork, EKG, wound inspection, and echocardiography are performed in addition to LVAD analysis. The role of the outpatient clinic is to detect early signs of deterioration or problems and act accordingly to prevent serious complications. : Thirty-three patients (68.7%) are still alive in 2025; two patients (4.2%) had a successful heart transplantation; and thirty-one patients (64.5%) are still on LVAD support. There were 210 total patient years of support. The mean time on device is 4.4 years. During the follow-up period we noticed 15 deaths (31.3%). Notably, there was no technical device-related death. Kaplan-Meier analysis estimated an overall survival rate of 97.9%, 92.8%, 83.7%, and 51.1% at 1, 2, 4, and 8 years, respectively. : Strict control of patients after discharge in an outpatient clinic is essential for the long-term survival of these patients. A well-structured outpatient program is of utter importance to avoid LVAD-related complications and should be a cornerstone for the treatment, especially in non-transplant centers.
在植入完全磁悬浮的雅培HeartMate 3（HM3）左心室辅助装置（LVAD）的晚期心力衰竭患者中，LVAD门诊的作用如何影响出院后的长期生存尚不清楚。我们的目标是分享我们的门诊护理标准化方案，描述LVAD门诊在LVAD植入术后长期护理中的作用，并报告生存率。
我们回顾性分析了2015年9月至2025年1月期间在我院植入HM3 LVAD的所有患者。接受HeartWare心室辅助装置（HVAD）和HeartMate 2 LVAD装置的患者被排除在我们的研究之外，以确保有一个专注于最新且目前唯一使用的LVAD装置一代的同质队列。我们共纳入了48例患者。LVAD患者从我们中心出院后，在我们的门诊每3个月随访一次。在随访期间，除了LVAD分析外，还进行血液检查、心电图、伤口检查和超声心动图检查。门诊的作用是检测恶化或问题的早期迹象，并采取相应措施预防严重并发症。2025年仍有33例患者（68.7%）存活；2例患者（4.2%）成功进行了心脏移植；31例患者（64.5%）仍在接受LVAD支持。总共有210个患者支持年。装置平均使用时间为4.4年。在随访期间，我们注意到15例死亡（31.3%）。值得注意的是，没有与装置技术相关的死亡。Kaplan-Meier分析估计1年、2年、4年和8年的总生存率分别为97.9%、92.8%、83.7%和51.1%。出院后在门诊对患者进行严格控制对这些患者的长期生存至关重要。一个结构良好的门诊计划对于避免LVAD相关并发症至关重要，并且应该是治疗的基石，尤其是在非移植中心。
