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.