Abstract 3342: Comparison of the Hemodynamic and Exercise Performance of Pulsatile (HeartMate XVE) and Continuous Flow (HeartMate II) LVADs
Background: Rotary pumps with fixed-speed, continuous flow design are increasingly utilized for LVAD support. The efficacy of this pump design compared to auto-regulated pulsatile-type LVADs with respect to degree of hemodynamic support, ventricular unloading, and exercise capacity remains largely unstudied.
Methods: 29 patients underwent LVAD implantation (pulsatile-type LVAD (HeartMate XVE) = 17; continuous flow-type LVAD (HeartMate II) = 12) at the UMich from 3/24/04 to 3/16/06 and were evaluated with right heart catheterization and echocardiography preoperatively and 3 mo postoperatively and cardiopulmonary exercise testing 3 mo postoperatively.
Results: LVAD support with either continuous- or pulsatile-type LVADs resulted in similar increases in CI and reduction in MPAP and PCWP. Exercise capacity at 3 mo was similar between groups. Echocardiography at 3 mo demonstrated a significantly greater reduction in LVEDV, LVESV, and degree of mitral regurgation for pulsatile compared to continuous flow LVAD (*p<0.05 compared to base; &p<0.05 compared to HMII). EF improved in the pulsatile LVAD group only.
Conclusions: Each LVAD design is equivalent with respect to degree of hemodynamic support (LV pressure unloading) and exercise capacity. Pulsatile-type LVADs are associated with smaller LV size (LV volume unloading). These differences may be attributable to differences in native vs. LVAD flow with each device and may have long-term implications for LV remodeling.