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The use of left ventricular assist devices in patients with advanced-stage heart failure is beleaguered by hemocompatibility-related complications of thrombosis, stroke, and bleeding, which are consequences of adverse interactions between the pump and circulating blood elements. (Funded by Abbott MOMENTUM 3 number, NCT02224755.) Introduction
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ConclusionsĪmong patients with advanced heart failure, a fully magnetically levitated centrifugal-flow left ventricular assist device was associated with less frequent need for pump replacement than an axial-flow device and was superior with respect to survival free of disabling stroke or reoperation to replace or remove a malfunctioning device. The numbers of events per patient-year for stroke of any severity, major bleeding, and gastrointestinal hemorrhage were lower in the centrifugal-flow pump group than in the axial-flow pump group. Pump replacement was less common in the centrifugal-flow pump group than in the axial-flow pump group (12 patients vs. In the analysis of the primary end point, 397 patients (76.9%) in the centrifugal-flow pump group, as compared with 332 (64.8%) in the axial-flow pump group, remained alive and free of disabling stroke or reoperation to replace or remove a malfunctioning device at 2 years (relative risk, 0.84 95% confidence interval, 0.78 to 0.91 P<0.001 for superiority). This final analysis included 1028 enrolled patients: 516 in the centrifugal-flow pump group and 512 in the axial-flow pump group. The principal secondary end point was pump replacement at 2 years. The composite primary end point was survival at 2 years free of disabling stroke or reoperation to replace or remove a malfunctioning device. We randomly assigned patients with advanced heart failure to receive either the centrifugal-flow pump or the axial-flow pump irrespective of the intended goal of use (bridge to transplantation or destination therapy). In two interim analyses of this trial, patients with advanced heart failure who were treated with a fully magnetically levitated centrifugal-flow left ventricular assist device were less likely to have pump thrombosis or nondisabling stroke than were patients treated with a mechanical-bearing axial-flow left ventricular assist device. Original Article A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report List of authors. The most trusted, influential source of new medical knowledge and clinical best practices in the world.
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