OVERVIEW OF MAJOR COMPLICATIONS FOLLOWING HEARTMATE 3 (HM3) LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION

Wiktoria Łuniewska; Agata Mytych; Julia Jackowska; Weronika Wrona; Wiktoria Wdowiak

doi:10.31435/ijitss.4(48).2025.4797

Wiktoria Łuniewska Student, Medical University of Wroclaw, Wroclaw, Poland https://orcid.org/0009-0009-5398-422X
Agata Mytych Student, Medical University of Wroclaw, Wroclaw, Poland https://orcid.org/0009-0004-4575-6327
Julia Jackowska Student, Medical University of Wroclaw, Wroclaw, Poland https://orcid.org/0009-0002-1725-0711
Weronika Wrona Student, Medical University of Wroclaw, Wroclaw, Poland https://orcid.org/0009-0000-5384-9313
Wiktoria Wdowiak Student, Medical University of Wroclaw, Wroclaw, Poland https://orcid.org/0009-0007-0388-914X

DOI: https://doi.org/10.31435/ijitss.4(48).2025.4797

Keywords: Heartmate 3, Left Ventricular Assist Device, LVAD Complications, Neurological Complications, Stroke, Bleeding, Pump Thrombosis, Driveline Infection, Survival Outcomes, Destination Therapy, Bridge to Transplant

Abstract

The HeartMate 3 (HM3) left ventricular assist device (LVAD) has become the current standard for mechanical circulatory support in patients with advanced heart failure. Its innovative design, including a fully magnetically levitated rotor and artificial pulse generation, has improved hemocompatibility and reduced mechanical failures. However, device-related complications remain a significant concern affecting patient outcomes. The main side effects of HM3 implantation, such as bleeding, infections, neurological events, and pump thrombosis, are examined in this review along with how they affect survival. Data from major clinical trials and observational studies were examined to identify complication rates, risk factors, and trends over time. Bleeding is the most frequent adverse event, occurring in approximately one-third of patients, with gastrointestinal bleeding observed in nearly 10%. 23–30% of recipients experience infections, especially driveline infections, and 3–5% experience neurological problems like ischaemic and hemorrhagic stroke, usually in the first six months following implantation. Pump thrombosis rates with HM3 remain among the lowest reported, ranging from 1.4% at two years to 2.8% at five years. Long-term results are positive in spite of these difficulties, with survival rates surpassing 80% at two years and 58% at five. Continued refinement of device technology and patient management is essential to further reduce complications and improve overall survival and quality of life.

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