METHODS
A retrospective analysis was conducted. We examined 50 consecutive patients who underwent Full MagLev™, HeartMate 3  continuous-flow LVAD (cf-LVAD) implantation for end-stage heart failure at our department from November 2015 to December 2019. A written informed consent was obtained from all the patietns. LVAD pump speed was optimized perioperatively in the intensive care unit using Swan-Ganz catheter measurements and echocardiography aiming for neutral interventricular septum position and intermittent aortic valve opening with minimal aortic regurgitation. After LVAD implantation, all patients received optimal heart failure medication and anticoagulation. The inclusion were as follows: LVAD support for at least six months with a stable clinical and hemodynamic status in the ambulatory setting. Finally, 38 patients who underwent ramp test during right-sided heart catheterization after LVAD implantation were included in this study. Excluded from the study were: two patients with severe tricuspid regurgitation, who were candidates for temporary right ventricular support; one patient who was supported preoperatively with extracorporeal membrane oxygenation or extracorporeal left ventricular support; two patients who died as a consequence of significant events occurring post-LVAD implantation; and seven patients who did not undergo postoperative ramp testing. The study was approved by the Ethical committee at Rome San Camillo Hospital and all the patients were enrolled with informed consent.