HeartMate II left ventricular assist device; early European experience.
OBJECTIVE
The novel axial flow left ventricular assist device HeartMate II was introduced into clinical practice in Europe as part of the pilot study and after CE approval in November 2005. In order to get an overview of the use and performance of the device in Europe a group of investigators was founded to compare the initial results.


METHODS
In a retrospective analysis of the first 101 consecutive cases in Europe, data were collected with regard to postoperative outcome and severe adverse events and anticoagulation protocols. Results were stratified by intention to treat as a bridge to transplant or as chronic support therapy in heart failure (destination therapy).


RESULTS
In 70% of patients, the HeartMate II was intended as a bridge to transplant therapy, in 30%, it was used as a destination therapy device. The perioperative mortality post implant was 20% in the bridge to transplant patients and 7% in the destination therapy arm. However, after 1 year a comparable survival was observed in both groups (69% destination therapy, 63% bridge to transplant). Main causes of death were multiple organ failure (n=12) and cerebrovascular accidents (n=5). All, but one cerebrovascular accident occurred in the first 9 days after surgery. Only one other death was reported thereafter and there was no mechanical failure of the device.


CONCLUSIONS
Even in the early experience the HeartMate II was used as a chronic support device in a substantial number of patients in Europe. Although the total experience is still limited, the incidence of cerebrovascular accidents is very low and the survival beyond the perioperative period is excellent.
Strüber
Martin
M
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. strueber.martin@mh-hannover.de
Sander
Kare
K
Lahpor
Jaap
J
Ahn
Henrik
H
Litzler
Pierre-Yves
PY
Drakos
Stavros G
SG
Musumeci
Francesco
F
Schlensak
Christian
C
Friedrich
Ivar
I
Gustafsson
Ronny
R
Oertel
Frank
F
Leprince
Pascal
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D004812:Epidemiologic Methods; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D011183:Postoperative Complications; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome
D000925:Anticoagulants