Abstract
Objectives: Six months after withdrawal of the HeartWare HVAD System (HVAD; Medtronic) from sale, approximately 4000 patients continue ongoing support with this device. In light of the diminishing experience, this global consensus document summarizes key management recommendations. Methods: International experts with experience in the management of patients with ongoing HVAD support were invited to summarize key aspects of patient and pump management and highlight differences in the current HeartMate 3 (Abbott Laboratories) ventricular assist device. Clinicians from high-implanting HVAD sites reviewed current literature and reported experience to generate a consensus statement. Results: Specific guidelines to assist in the management of ongoing HVAD patients are developed. Key management protocols and helpful techniques developed from experienced clinicians are combined into a short guideline document. As experience with HeartMate 3 increases, key differences in approach to management are highlighted, where appropriate. Conclusions: With decreasing worldwide experience in the ongoing management of HVAD-supported patients, this consensus guideline provides a summary of best practice techniques from international centers. Differences in HeartMate 3 management are highlighted.
Original language | English (US) |
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Pages (from-to) | 1120-1137.e2 |
Journal | Journal of Thoracic and Cardiovascular Surgery |
Volume | 164 |
Issue number | 4 |
DOIs | |
State | Published - Oct 2022 |
Funding
Christopher Hayward, MD, MBBS: honoraria/consultant from Abbott Inc and Medtronic; Iki Adachi, MD: consultant and proctor for Berlin Heart Inc, Medtronic, Jarvik Inc, BiVACOR Inc, and Sony-Olympus Medical Solutions Inc; Erin Davis, BSN, RN: consultant to Medtronic; Erika D. Feller, MD: advisor/consultant/advisory boards/honoraria—Medtronic; Koichiro Kinugawa, MD, PhD: advisor/consultant/advisory boards/honoraria—Medtronic; Liviu Klein, MD, MS: consultant for Medtronic and Abbott, Inc; Angela Lorts, MD, MBA: consultant/educational grant—Abbott Inc, Berlin Heart, Syncardia, Medtronic, and Abiomed; Claudius Mahr, DO: consultant and investigator for Abbott, Inc, Medtronic, Abiomed, Carmat, and Syncardia; Jacob Mathew, MBBS: consultant for Medtronic; Marcus Müller, MD: consultant and advisor for Medtronic; Minoru Ono, MD, PhD: consultant for Medtronic; Francis D. Pagani, MD, PhD: noncompensated scientific advisor for FineHeart, Inc, Member of the Data Safety Monitoring Board for Carmat and the National Heart, Lung, and Blood Institute PumpKIN Clinical Study; Jonathan Rich, MD: consultant for Abbott Inc, and Medtronic; Desiree Robson, RN, BSc(Hons): travel grants Abbott Inc and Medtronic; David N. Rosenthal, MD: no direct financial conflict of interest. Serves as co-Director of ACTION, which has received financial support from Berlin Heart, Medtronic, and Abbott, Inc, and consultant for the Department of Justice but this was not related in any manner to the publication; Diyar Saeed, MD, PhD: consultant for Abbott Inc, Medtronic, and Abiomed; Christopher Salerno, MD: consultant for Medtronic and Abbott Inc; Andrew J. Sauer, MD: speaking/consulting for Medtronic, Abbott, Boston Scientific, Edwards Life Sciences, and Impulse Dynamics; Thomas Schlöglhofer, MSc: consultant and advisor, and has received research grants from Medtronic and Abbott, Inc; Laurens Tops, MD, PhD: consultant for Medtronic. All other authors reported no conflicts of interest. Christopher Hayward, MD, MBBS: honoraria/consultant from Abbott Inc and Medtronic; Iki Adachi, MD: consultant and proctor for Berlin Heart Inc, Medtronic, Jarvik Inc, BiVACOR Inc, and Sony-Olympus Medical Solutions Inc; Erin Davis, BSN, RN: consultant to Medtronic; Erika D. Feller, MD: advisor/consultant/advisory boards/honoraria—Medtronic; Koichiro Kinugawa, MD, PhD: advisor/consultant/advisory boards/honoraria—Medtronic; Liviu Klein, MD, MS: consultant for Medtronic and Abbott, Inc; Angela Lorts, MD, MBA: consultant/educational grant— Abbott Inc, Berlin Heart , Syncardia , Medtronic , and Abiomed ; Claudius Mahr, DO: consultant and investigator for Abbott, Inc, Medtronic, Abiomed, Carmat, and Syncardia; Jacob Mathew, MBBS: consultant for Medtronic; Marcus Müller, MD: consultant and advisor for Medtronic; Minoru Ono, MD, PhD: consultant for Medtronic; Francis D. Pagani, MD, PhD: noncompensated scientific advisor for FineHeart, Inc, Member of the Data Safety Monitoring Board for Carmat and the National Heart, Lung, and Blood Institute PumpKIN Clinical Study; Jonathan Rich, MD: consultant for Abbott Inc, and Medtronic; Desiree Robson, RN, BSc(Hons): travel grants Abbott Inc and Medtronic ; David N. Rosenthal, MD: no direct financial conflict of interest. Serves as co-Director of ACTION, which has received financial support from Berlin Heart , Medtronic , and Abbott , Inc, and consultant for the Department of Justice but this was not related in any manner to the publication; Diyar Saeed, MD, PhD: consultant for Abbott Inc, Medtronic, and Abiomed; Christopher Salerno, MD: consultant for Medtronic and Abbott Inc; Andrew J. Sauer, MD: speaking/consulting for Medtronic, Abbott, Boston Scientific, Edwards Life Sciences, and Impulse Dynamics; Thomas Schlöglhofer, MSc: consultant and advisor, and has received research grants from Medtronic and Abbott , Inc; Laurens Tops, MD, PhD: consultant for Medtronic. All other authors reported no conflicts of interest.
Keywords
- HeartWare HVAD
- adverse events
- anticoagulation
- blood pressure
- left ventricular assist device
- management guidelines
ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine