Key result
HeartMate 3 achieves ~64% 5-year survival, with similar outcomes for destination therapy versus bridge-to-transplant.
Why the study?
The HeartMate 3 LVAD is an established therapy for advanced heart failure, but contemporary real-world data from low- or medium-volume centres remain limited.
Does HeartMate 3 LVAD implantation provide durable survival on LVAD support in adult patients with advanced heart failure in a medium-volume tertiary centre?
Cohort (n=100)
No
Does HeartMate 3 LVAD implantation provide durable survival on LVAD support in adult patients with advanced heart failure in a medium-volume tertiary centre?
HeartMate 3 LVAD therapy in a Swiss medium-volume centre achieved a 64% five-year survival on support, demonstrating durable outcomes comparable to large multicentre registries.
Answers are grounded in this paper and cite their sources.
Supports HeartMate 3 durability in real-world European practice; extends multicentre registries but remains hypothesis-generating.
INTRODUCTION: The HeartMate 3 left ventricular assist device (LVAD) is an established therapy for advanced heart failure, yet contemporary real-world data from low- or medium-volume centres remain limited. We aimed to describe the characteristics, management and clinical outcomes of patients undergoing HeartMate 3 LVAD implantation at a Swiss tertiary centre. METHODS: We conducted an observational study including consecutive adult patients who underwent HeartMate 3 implantation at Lausanne University Hospital between November 2015 and January 2026. Baseline characteristics, INTERMACS profiles, perioperative data, survival and LVAD-related complications were assessed. The primary outcome was survival on LVAD support. Comparisons by LVAD indication were pre-specified exploratory analyses (destination therapy vs bridge-to-transplant). Survival analyses on LVAD support, with heart transplantation or LVAD explantation treated as censoring events, were reported. RESULTS: A total of 100 patients (mean age 58 [standard deviation 12] years, 84% male, 29% destination therapy) underwent HeartMate 3 implantation. Ischaemic heart disease was the predominant aetiology (69%) and most patients (68%) were classified as INTERMACS profiles 3-4 at implantation. Over a median follow-up of 1.5 (IQR 0.5-3) years, 27 patients died on LVAD support, corresponding to a mortality incidence rate (IR) of 13.5 deaths per 100 patient-years, while 51 patients underwent heart transplantation, corresponding to an IR of transplantation of 25.4 per 100 patient-years. Five-year survival on LVAD support was 64%, with patients censored at LVAD explantation for recovery or transplantation. LVAD-related complications included bleeding (48%), infection (50%), ischaemic stroke (12%) and right ventricular failure (39%). Survival did not differ by LVAD indication (bridge-to-transplant as reference, adjusted HR 0.62, 95% CI 0.14-2.72). CONCLUSIONS: In this contemporary, real-world, medium-sized cohort, HeartMate 3 therapy provided durable long-term support across a broad spectrum of advanced heart failure patients, with outcomes consistent with those reported in large multicentre registries.
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Nowacka et al. (2026) conducted a cohort in Advanced heart failure (n=100). HeartMate 3 LVAD implantation (Destination therapy vs Bridge-to-transplant) vs. Bridge-to-transplant (BTT) was evaluated on Survival on LVAD support (with heart transplantation or explantation for recovery treated as censoring events) (adjusted HR 0.62, 95% CI 0.14-2.72). HeartMate 3 LVAD therapy achieved 85% 1-year and 64% 5-year survival on support, with no significant difference between destination therapy and bridge-to-transplant (adjusted HR 0.62, 95% CI 0.14-2.72).
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