New cardiac pump device improves long-term outcomes for heart failure patients

March 11, 2018, Brigham and Women's Hospital

New findings, presented today at the American College of Cardiology, provide long-term information about survival, stroke rates and durability of a novel centrifugal-flow pump compared with a commercial axial flow pump for heart-failure patients. BWH investigators report that patients who received the centrifugal-flow pump had significantly lower rates of pump-related blood clots and stroke. Results from the MOMENTUM 3 trial's analysis at 24 months were presented in a Late Breaking Clinical Trial at ACC by Mandeep R. Mehra, MD, executive director of the Center for Advanced Heart Disease and medical director of the Heart & Vascular Center at Brigham and Women's Hospital, and published simultaneously online in the New England Journal of Medicine.

"This is a pivotal study in the field of advanced heart failure," said Mehra. "Left ventricular assist devices have been in development for 40 years and there have been improvements in their technology but several challenges exist, including problems of blood clots forming in these devices, requiring device replacement. The field has been trying to engineer devices that could obviate some or all of these problems, and we report today on some important advances."

MOMENTUM 3, sponsored by Abbott Inc., evaluated Abbott's HeartMate 3 left ventricular assist system, a magnetically-levitated continuous centrifugal-flow circulatory pump, compared to the HeartMate II. The trial evaluated how many participants, two years after receiving their device, had not suffered a disabling or had an operation to replace or remove a malfunctioning device. A total of 366 were randomized to receive either the centrifugal flow pump or the axial flow pump. Researchers report that 151 of 190 patients on the centrifugal flow pump did not experience a disabling stroke or need a re-operation (79.5 percent) compared to 106 of 176 of the patients (60.2 percent) on the axial pump. Only three people who received the centrifugal-flow pump needed a re-operation compared to 30 who received the axial pump. No re-operations occurred due to blood clots in the centrifugal-flow pump. Deaths or disabling strokes were similar between the two groups, but overall, stroke rates were less frequent in the centrifugal-flow pump group. Bleeding and infection rates were no different between the two groups.

MOMENTUM 3 launched in 2014 and was designed to dramatically reduce the overall timeline for clinical trials. All patients with refractory heart failure who needed a cardiac pump were eligible for the trial, regardless of whether the pump was intended as bridge to transplantation or destination therapy.

"Traditional trials must undergo safety testing, followed by testing in healthier populations, and it can be over a decade before the broader population has access to such therapies," said Mehra. "Removing restrictions based on transplant status resulted in a unique study that has been extremely successful in its enrollment and highly expeditious in delivering results."

The HeartMate 3 includes several technological adaptations intended to reduce risk of complications. The fully magnetically levitated runs like a bullet train—its rotor has no mechanical bearings in it and pushes the blood using only magnetism. It is designed to reduce shear stress, which is thought to cause to form in pumps.

In its next phase, MOMENTUM 3 will evaluate 1,028 patients at the two-year mark to further validate the current findings. Results of the full cohort are expected by the end of 2019.

Explore further: Patients on HeartMate 3 have fewer blood-related events than those on HeartMate II

Related Stories

Patients on HeartMate 3 have fewer blood-related events than those on HeartMate II

April 6, 2017
A six-month analysis of the pivotal MOMENTUM 3 trial found that patients implanted with the new HeartMate 3 left ventricular assist system (LVAS) had fewer adverse clotting and bleeding events than patients implanted with ...

Centrifugal-flow left ventricular assist device noninferior

February 3, 2017
(HealthDay)—For patients with advanced heart failure, a newer-design centrifugal-flow left ventricular assist device (LVAD) is noninferior to an axial-flow LVAD, according to a study published in the Feb. 2 issue of the ...

Are blood clots in patients with heart-assist pumps decreasing or on the rise in 2015?

December 3, 2015
More left ventricular assist devices (LVADs), a mechanical heart that helps pump blood, are now implanted annually than hearts transplanted in patients with advanced stages of heart failure. Evidence-based data indicate that ...

On-pump CABG leads to higher rates of five-year survival

August 18, 2017
(HealthDay)—Five years after coronary-artery bypass grafting (CABG) surgery, patients whose operation was performed with cardiopulmonary bypass (on pump) lived longer than those whose surgeons performed the procedure without ...

Recommended for you

Noisy workplace may wreak havoc on your heart

March 22, 2018
(HealthDay)—Loud noise at work doesn't just threaten your hearing, it might also boost your blood pressure and cholesterol levels, a new U.S. government report suggests.

Smartwatch effective in detecting atrial fibrillation

March 22, 2018
Irregular heart impulses that lead to stroke can be detected with great accuracy using a smartwatch with a specially designed application, a finding that could eventually lead to new ways to screen patients for earlier treatment, ...

AI is quicker, more effective than humans in analyzing heart scans

March 22, 2018
A type of artificial intelligence known as advanced machine learning can classify essential views from heart ultrasound tests faster, more accurately and with less data than board-certified echocardiographers, according to ...

Majority of U.S. adults have poor heart health: study

March 19, 2018
(HealthDay)—America's heart health went from bad to worse between 1988 and 2014, a new report warns.

Drinking alcohol makes your heart race

March 18, 2018
The more alcohol you drink, the higher your heart rate gets, according to research presented today at EHRA 2018 Congress, organized by the European Society of Cardiology.

Study of nearly 300,000 people challenges the 'obesity paradox'

March 15, 2018
The idea that it might be possible to be overweight or obese but not at increased risk of heart disease, otherwise known as the "obesity paradox", has been challenged by a study of nearly 300,000 people published in in the ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.