OC30 HEMOCOMPATIBILITY-RELATED ADVERSE EVENTS AND PHYSIOLOGICAL CIRCULATORY INTERFACE OF DIFFERENT GENERATION LEFT VENTRICULAR ASSIST DEVICES

Abstract Background and Aim: Aim of this study has been to assess the rate of hemocompatibility-related adverse events (HRAEs) of current generation centrifugal pumps and older axial continuous-flow (CF) left ventricular assist devices (LVADs). Methods: We identified 193 CF LVAD recipients at three institutions. We studied the quantitative estimates of freedom from HRAEs between 3 types of pumps, the HeartMate II (HMII,n = 56), the HeartMate 3 (HM3,n = 38) and the HeartWare HVAD (HVAD,n = 99). The net burden of HRAE was assessed by using the MOMENTUM 3 hemocompatibility score. Results: Survival free of any HRAE was achieved in 86% of the HM3 group, 64% of the HMII group and 52% in HVAD group (hazard ratio, 0.64; confidence interval, 0.40–0.95; p = 0.014). Using the hemocompatibility score, the HM3 group demonstrated less pump thrombosis requiring reoperation (0 versus 6 and 14 points, for HMII and HVAD, respectively, p = 0.002) or medically managed pump thrombosis (0 versus 4 points and 17 points, for HMII and HVAD, respectively, p = 0.001), and fewer nondisabling strokes (6 versus 14 and 30 points, for HMII and HVAD, respectively, p = 0.002). The net hemocompatibility score in the HM3 in comparison with the HMII and HVAD patients was 71 (0.66 ± 1.45 points/patient) versus 103 (0.86 ± 1.59 points/patient) and 157 (0.96 ± 1.71 points/patient), respectively (odds ratio, 0.66; confidence interval, 0.38–1.01; p = 0.063). Conclusions: In this analysis, HM3 had a more favorable physiological circulatory interface at 36 months in comparison with HMII and HVAD. This confirms the need to develop different clinical monitorings and coagulation management protocols when facing with various device platforms.