[ISPHLT-SY5-3] The impact of HeartMate 3 left ventricular assist device in small BSA patients
It is still challenging to implant left ventricular assist device (LVAD) designed for adult patients into small body surface area (BSA) patients or congenital patients. Methods: From April 2013 to February 2021, 171 patients received HeartMate II (HM II, n=120) or HeartMate 3 (HM3, n=51) in our institute. There were 41 patients (24%, small group), 30 patients with HM II and 11 patients with HM3, whose BSA was less than 1.5m2. Others (n=130) were classified in large group. Mid-term outcomes including survival, stroke and composite outcome of death, stroke and pump exchange were examined. Anticoagulation protocol was same in bath group.Results: The pump speed and BSA were linearly related, and therefore, pump speed was low in small BSA patients. The log-rank test revealed that there were no significant differences between small group and large group in survival, freedom from stroke and freedom from composite outcomes (p=0.683, 0.130, 0.905). The 3-year freedom from stroke was 86% in large group and 78% in small group. There were 9 patients (22%) in small group and 17 (13%) patients in large group among all observation periods. Patients with stroke more than modified Rankin scale 3 were 3 (7%) in small group and 5 (4%) in large group. To compare HM II and HM3, there was only 1 patient who had stroke in HM3 group and the freedom from stroke was significantly higher in HM3 group (p=0.031). Conclusion: Although surgical technique and post-operative management were more delicate in small BSA patients, the outcomes were not inferior. HM3 is a promising device for small BSA patients.