Left-ventricular assist device (LVAD) technology has proven a lifesaver for many patients with heart failure. However, these implanted electromechanical systems can be agents of blood flow blockage, or thrombosis. The results of a recent two-year trial show a reduced incidence of pump thrombosis associated with Abbott’s HeartMate 3 centrifugal-flow LVAD.

The Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 (MOMENTUM 3) compared outcomes for 1,028 advanced-stage heart failure patients receiving either the centrifugal-flow device or the older HeartMate II axial-flow device. The results are The HeartMate 3. Source: Abbottpublished in The New England Journal of Medicine.

Almost 77% of subjects in the centrifugal-flow pump group did not experience a disabling stroke or need a re-operation compared to 65% in the axial-flow pump group. Only 12 who received the centrifugal-flow pump needed a re-operation compared to 57 who received the axial pump. The new HeartMate 3 reduced risk of stroke by 58% and major bleeding by 36%; infection rates and rates of right heart failure were no different between the two groups.

The fully magnetically levitated LVAD pushes the blood using only magnetism and is designed to reduce shear stress and destruction of blood elements as they pass through the pump, which is thought to cause blood clot formation. Since infections are still a frequent occurrence and particularly affect the drive line exit site, research efforts should be devoted to engineering internally powered heart pumps that eliminate the drive line.

Researchers from Brigham and Women’s Hospital (Massachusetts), University of Chicago, Abbott, Columbia University, New York–Presbyterian Hospital, Montefiore Einstein Center for Heart and Vascular Care (New York), University of Colorado School of Medicine, St. Vincent Heart Center (Indiana), Duke University Medical Center, University of North Carolina, Baptist Health Medical Center (Arkansas), Washington University School of Medicine, St. Louis, Advent Health Transplant Institute (Florida), University of Minnesota, Houston Methodist Hospital, University of Nebraska Medical Center, Yale Medical School, MedStar Washington Hospital Center (Washington, DC), University of Michigan, St. Thomas Hospital (Tennessee) and Piedmont Hospital (Georgia) contributed to this study.