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Outcomes in Smaller Body Size Adults after HeartMate 3 Left Ventricular Assist Device Implantation.

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Citation: Annals of Thoracic Surgery. 2022 Apr 19PMID: 35452663Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022 ISSN:

0003-4975

Name of journal: The Annals of thoracic surgeryAbstract: BACKGROUND: Outcomes in patients with smaller body size following HeartMate 3 Left Ventricular Assist Device (HM3) implantation are not well characterized. We sought to evaluate outcomes in smaller vs. larger BSA patients in the MOMENTUM 3 pivotal trial and its Continued Access Protocol cohort.CONCLUSIONS: Outcomes following HM3 implantation were comparable between small and large patients. Smaller body size should not be used to deny HM3 implantation in patients who are otherwise suitable durable MCS candidates. Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.METHODS: The analysis cohort included 1015 HM3 patients divided into 2 groups: BSA<=1.70 m2 (small patients, n=82) and BSA>1.70 m2 (large patients, n=933). The composite primary endpoint was survival at 2-years free of disabling stroke or reoperation to replace or remove a malfunctioning device. Adverse events were compared between groups.RESULTS: Smaller patients were more frequently women (56.1% vs. 17.7%, P<.001), had lower prevalence of diabetes (28.1% vs. 43.9%, P=.005) and hypertension (51.2% vs. 71.9%, P<.001), larger median indexed LVEDD (normalized by BSA, 40 vs. 33 mm/m2, P<.001), and lower median serum creatinine (1.1 vs. 1.3 mg/dl, P<.001). The proportion of patients achieving the composite endpoint at 2-years was 77% in both groups (adjusted HR = 1.14 [95% confidence interval: 0.68-1.91], P=.62). Two-year adverse event rates were also similar between groups except for sepsis (6.1% vs. 14.9%, P=.029) and cardiac arrhythmias (24.4% vs. 35.3%, P=.005), which were higher in the larger patients.All authors: Bourque K, Chuang J, Cleveland JC Jr, Cowger J, Goldstein DJ, Horstmanshof D, Lee S, Mehra MR, Molina EJ, Naka Y, Salerno CT, Uriel NFiscal year: FY2022 Digital Object Identifier:

https://dx.doi.org/10.1016/j.athoracsur.2022.03.071

Date added to catalog: 2022-05-11

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	35452663	Available		35452663

BACKGROUND: Outcomes in patients with smaller body size following HeartMate 3 Left Ventricular Assist Device (HM3) implantation are not well characterized. We sought to evaluate outcomes in smaller vs. larger BSA patients in the MOMENTUM 3 pivotal trial and its Continued Access Protocol cohort.

CONCLUSIONS: Outcomes following HM3 implantation were comparable between small and large patients. Smaller body size should not be used to deny HM3 implantation in patients who are otherwise suitable durable MCS candidates. Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

METHODS: The analysis cohort included 1015 HM3 patients divided into 2 groups: BSA<=1.70 m2 (small patients, n=82) and BSA>1.70 m2 (large patients, n=933). The composite primary endpoint was survival at 2-years free of disabling stroke or reoperation to replace or remove a malfunctioning device. Adverse events were compared between groups.

RESULTS: Smaller patients were more frequently women (56.1% vs. 17.7%, P<.001), had lower prevalence of diabetes (28.1% vs. 43.9%, P=.005) and hypertension (51.2% vs. 71.9%, P<.001), larger median indexed LVEDD (normalized by BSA, 40 vs. 33 mm/m2, P<.001), and lower median serum creatinine (1.1 vs. 1.3 mg/dl, P<.001). The proportion of patients achieving the composite endpoint at 2-years was 77% in both groups (adjusted HR = 1.14 [95% confidence interval: 0.68-1.91], P=.62). Two-year adverse event rates were also similar between groups except for sepsis (6.1% vs. 14.9%, P=.029) and cardiac arrhythmias (24.4% vs. 35.3%, P=.005), which were higher in the larger patients.

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