«Bridge to transplantation». First experience in Ukraine using the LVAD CorHeart 6 system
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https://orcid.org/0009-0005-9467-1669
Abstract
The range of mechanical circulatory support (MCS) devices used for two-stage heart transplantation is quite wide – starting from the implantation of an artificial heart, biventricular bypass, left ventricular bypass (LVAD) and ending with the connection of an extracorporeal membrane oxygenation (ECMO) system. The duration of use of these technologies depends on the chosen MCS method. In particular, LVAD using implanted pumps involves long-term connection of the systems (from a month to several years). The advantage of such systems is the ability for the patient to leave the clinic and maintain an active lifestyle. We present the first experience of implantation of the CorHeart 6 LVAD system in Ukraine. We retrospectively collected preoperative information, treatment course, and clinical outcomes.
Conclusions. LVAD systems are the most effective «bridge» to transplantation, because: unload damaged ventricles of the heart: reduce the size, volume and mass of the ventricles; provide effective circulatory support; preserve and improve the functioning of organs and systems, prevent the development of complications of chronic heart failure; increase survival, significantly improve the quality of life and functional status of patients compared to drug therapy.
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Jorde UP, Saeed O, Koehl D, Morris AA, Wood KL, et al. Jan., The Society of Thoracic Surgeons Intermacs 2023 Annual Report: Focus on Magnetically Levitated Devices. Ann Thorac Surg. 2024 Jan;117(1):33-44. https://doi.org/10.1016/j.athoracsur.2023.11.004
Bourque K, Cotter C, Dague C, Harjes D, et al. Design rationale and preclinical evaluation of the heartmate 3 left ventricular assist system for hemocompatibility. ASAIO J. 2016 Jul-Aug;62(4):375-83. https://doi.org/10.1097/MAT.0000000000000388
Mehra MR, Uriel N, Naka Y, Cleveland JC Jr, Yuzefpolskaya M, et al. Apr., A Fully Magnetically Levitated Left Ventricular Assist Device – Final Report, N Engl J Med. 2019 Apr 25;380(17):1618-1627. https://doi.org/10.1056/NEJMoa1900486
Malick A, Ning Y, Kurlansky PA, Melehy A, et al. Development of de Novo aortic insufficiency in patients with heartmate 3. Ann Thorac Surg. 2022 Aug;114(2):450-456. https://doi.org/10.1016/j.athoracsur.2021.08.074
Romero Dorta E, Meyn R, Müller M, Hoermandinger C, et al. Potential benefits of aortic valve opening in patients with left ventricular assist devices. Artif Organs. 2025 Mar;49(3):441-450. https://doi.org/10.1111/aor.14891
Ayre PJ, Lovell NH, Woodard JC. Non-invasive flow estimation in an implantable rotary blood pump: a study considering non-pulsatile and pulsatile flows. Physiol Meas. 2003 Feb;24(1):179-89. https://doi.org/10.1088/09 67-3334/24/1/313
Bertram CD. Measurement for implantable rotary blood pumps, Physiol. Meas. 2005 Aug;26(4):99-117. https://doi.org/10.1088/0967-3334/26/4/R01
Naiyanetr P, Moscato F, Vollkron M, et al. Continuous assessment of cardiac function during rotary blood pump support: a contractility index derived from pump flow. J Heart Lung Transplant. 2010 Jan;29(1):37-44. https://doi.org/10.1016/j.healun.2009.05.032
Moscato F, Granegger M, Naiyanetr P, Wieselthaler G, Schima H. Evaluation of left ventricular relaxation in rotary blood pump recipients using the pump flow waveform: a simulation study. Artif Organs. 2012 May;36(5):470-8. https://doi.org/10.1111/j.1525-1594.2011.01392.x
Granegger M, Schima H, Zimpfer D, Moscato F. Assessment of aortic valve opening during rotary blood pump support using pump signals. Artif Organs. 2014 Apr;38(4):290-7. https://doi.org/10.1111/aor.12167
Granegger M, Masetti M, Laohasurayodhin R, et al. Continuous monitoring of aortic valve opening in rotary blood pump patients. IEEE Trans Biomed Eng. 2016 Jun;63(6):1201-7. https://doi.org/10.1109/TBME.2015.2489188
Hayward C, Lim CP, Schima H, et al. Pump speed waveform analysis to detect aortic valve opening in patients on ventricular assist device support. Artif Organs. 2015 Aug;39(8):704-9. https://doi.org/10.1111/aor.12570
Clifford R, Robson D, Gross C, Moscato F, et al. Beat-to-beat detection of aortic valve opening in heartware left ventricular assist device patients. Artif Organs. 2019 May;43(5):458-466. https://doi.org/10.1111/aor.13381
Moscato F, Granegger M, Edelmayer M, Zimpfer D, Schima H. Continuous monitoring of cardiac rhythms in left ventricular assist device patients. Artif Organs. 2014 Mar;38(3):191-8. https://doi.org/10.1111/aor.12141
Maw M, Gross C, et al. Development of Suction detection algorithms for a left ventricular assist device from patient data. Biomed Signal Process Control. Aug. 2021;69:102910. https://doi.org/10.1016/j.bspc.2021.102910
Belkin MN, Kagan V, Labuhn C, Pinney SP, Grinstein J. Physiology and clinical utility of heartmate pump parameters. J Card Fail. May 2022;28(5):845-862. https://doi.org/10.1016/j.cardfail.2021.11.016
Albert CL, Estep JD. How to optimize patient selection and device performance of the newest generation left ventricular assist devices. Curr Treat Options Cardiovasc Med. Aug. 2019;21(9):48. https://doi.org/10.1007/s11936-019-0748-x
Adamopoulos S, Bonios M, Ben Gal T, et al. Right heart failure with left ventricular assist devices: Preoperative, perioperative and postoperative management strategies. A clinical consensus statement of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2024 Nov;26(11):2304-2322. https://doi.org/10.1002/ejhf.3323
Schlöglhofer T, Gross C, Abart T, et al. HeartMate 3 Snoopy: noninvasive cardiovascular diagnosis of patients with fully magnetically levitated blood pumps during echocardiographic speed ramp tests and Valsalva maneuvers. J Heart Lung Transplant. 2024 Feb;43(2):251-260. https://doi.org/10.1016/j.healun.2023.09.011
Consolo F, Pieri M, Pazzanese V, Scandroglio AM, Pappalardo F. Longitudinal analysis of pump parameters over long-term support with the HeartMate 3 left ventricular assist device. J Cardiovasc Med (Hagerstown). 2023 Oct 1;24(10):771-775. https://doi.org/10.2459/JCM.0000000000001522
Uriel N, Morrison KA, Garan AR, et al. Development of a novel echocardiography ramp test for speed optimization and diagnosis of device thrombosis in Continuous-Flow left ventricular assist devices. J Am Coll Cardiol. 2012 Oct 30;60(18):1764-75. https://doi.org/10.1016/j.jacc.2012.07.052
Bender M, Escher A, Messner B, et al. An atraumatic mock loop for realistic hemocompatibility assessment of blood pumps. IEEE Trans Biomed Eng. 2024 May;71(5):1651-1662. https://doi.org/10.1109/TBME.2023.3346206
Colacino FM, Moscato F, Piedimonte F, et al. A modified elastance model to control mock ventricles in real-time: numerical and experimental validation. ASAIO ASAIO J. 2008 Nov-Dec;54(6):563-73. https://doi.org/10.1097/MAT.0b013e31818a5c93
Gupta S, Woldendorp K, Muthiah K, et al. Normalisation of haemodynamics in patients with end-stage heart failure with continuous-flow left ventricular assist device therapy. Heart Lung Circ. 2014 Oct;23(10):963-9. https://doi.org/10.1016/j.hlc.2014.04.259
Errill EW. Rheology of blood. Physiol Rev. Oct. 1969;49(4):863-888. https://doi.org/10.1152/physrev.1969.49.4.863
Késmárky G, Kenyeres P, Rábai M, Tóth K. Plasma viscosity: a forgotten variable. Clin Hemorheol Microcirc. 2008;39(1-4):243-6. https://pubmed.ncbi.nlm.nih.gov/18503132/
Uriel N, Burkhoff D, Rich JD, et al. Impact of hemodynamic ramp Test-Guided HVAD speed and medication adjustments on clinical outcomes: the RAMP-IT-UP multicenter study. Circ Heart Fail. 2019 Apr;12(4):e006067. https://doi.org/10.1161/CIRCHEARTFAILURE.119.006067
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307-10. https://pubmed.ncbi.nlm.nih.gov/2868172/
Reyes C, Voskoboynikov N, Chorpenning K, et al. Accuracy of the HVAD pump flow Estimation algorithm. ASAIO J. 2016 Jan-Feb;62(1):15-9. https://doi.org/10.1097/MAT.0000000000000295
Stephens AF, Mapley M, Wu EL, et al. HeartWare HVAD Flow Estimator Accuracy for Left and Right Ventricular Support. ASAIO J. 2021 Apr 1;67(4):416-422. https://doi.org/10.1097/MAT. 0 000000000001247
Melnyk AYu, Yaschenko NO. Clinical characteristics and course of refractory heart failure in patients depending on inclusion in the heart transplant waiting list. Cardiac Surgery and Interventional Cardiology. 2025;14(2):6-16 (Ukrainian). https://doi.org/10.31928/2664-3790-2025.2.616