Author + information
- Received December 17, 2015
- Revision received April 18, 2016
- Accepted April 21, 2016
- Published online July 3, 2017.
- Harry Magunia, MDa,∗ (, )
- David Schibilsky, MDb,
- Jan N. Hilberath, MDa,
- Christian Schlensak, MD, PhDb,
- Peter Rosenberger, MD, PhDa and
- Martina Nowak-Machen, MDa
- aDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany
- bDepartment of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Tübingen, Germany
- ↵∗Address for correspondence:
Dr. Harry Magunia, Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany.
- cardiac surgery
- circulatory support
- HeartMate 3
- left ventricular assist device
Recently, a fully magnetically levitated left ventricular assist device (LVAD) system (HeartMate 3, Thoratec, Pleasanton, California) has become clinically available (1). The centrifugal rotor of the pump head in this system allows large flow gaps around it. Due to an artificial pulse algorithm, the pump changes its rotational speed periodically every 2 s. Within 350 ms, pump speeds decrease by 2,000 rpm from baseline (for 150 ms), then increase by 4,000 rpm (for 200 ms), and lastly adjust back to previously programmed values. The aim of this feature is to rinse the pump and reduce potential thrombotic complications.
The implantation procedure, basic imaging requirements, and pump speed adjustments are comparable to other LVAD. However, there are 2 unique device-associated echocardiographic findings:
• Reverberation artifacts during color flow and spectral flow Doppler examination.
• Device-induced pulsatility of blood flows depicted by spectral Doppler important for discrimination between baseline flow and alternating velocities during the artificial pulse algorithm.
Because the fully magnetically levitated LVAD will soon be implanted globally, we share first insights and specific echocardiographic considerations regarding this novel device (Figures 1, 2, 3, 4, 5, and 6, Online Videos 1, 2, 3, 4, 5, 6, 7, 8, 9).
For supplemental videos, please see the online version of this article.
Drs. Schibilsky and Schlensak serve as consultants for Thoratec Ltd. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 17, 2015.
- Revision received April 18, 2016.
- Accepted April 21, 2016.
- 2017 American College of Cardiology Foundation
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