Fully magnetically levitated LVAD leads to better outcomes in advanced heart failure

Patients with advanced heart failure who received a fully magnetically levitated centrifugal-flow left ventricular assist device (LVAD) had better composite outcomes and a higher likelihood of overall survival at 5 years compared with patients who received an axial-flow LVAD, according to a study.

A total of 295 patients from the MOMENTUM 3 randomized trial were enrolled in the extended-phase study. In MOMENTUM 3 the centrifugal-flow LVAD to the axial-flow pump was found to be superior to the axial-flow pump in regard to survival to transplant, recovery, or LVAD support free of debilitating stroke or reoperation to replace the pump at 2 years. At 2 years, 536 were still receiving LVAD support. The current observational study was a 5-year follow-up of the MOMENTUM 3 trial.

Overall, 477 patients (295 enrolled and 182 provided limited data) contributed to the extended-phase analysis. The 5-year Kaplan-Meier estimate of survival to transplant, recovery, or LVAD support free of debilitating stroke or reoperation to replace the pump in the centrifugal-flow group was 54.0% versus 29.7% in the axial-flow group. Overall Kaplan-Meier survival was 58.4% in the centrifugal-flow group versus 43.7% in the axial-flow group.

In the centrifugal-flow pump group, there were less frequent serious adverse events including stroke, bleeding, and pump thrombosis

Reference
Mehra MR, Goldstein DJ, Cleveland JC, et al. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA.  2022;doi:10.1001/jama.2022.16197