Heartware ventricular assist device versus HeartMate II versus HeartMate III in advanced heart failure patients: A systematic review and meta-analysis.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL

SAGE Open Medicine Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI:10.1177/20503121241278226

Dudy Arman Hanafy, Theresia Feline Husen, Ruth Angelica, Ilona Nathania, Widya Trianita Suwatri, Pasati Lintangella, Wahyu Prima Erdianto, Prisillia Prasetyo

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引用次数: 0

Abstract

Objective: Ventricular assist device is one of the treatment options for heart failure patients. Therefore, the purpose of this review is to aid in clinical decision-making of exchanging previous older ventricular assist device models to the newest one, HM3.

Methods: The search was conducted across several databases until February 25, 2023, and was registered with the ID of CRD42023405367. Risk of bias was performed using Cochrane Risk of Bias 2.0 and the Newcastle Ottawa Scale. In order to rank and evaluate the pooled odds ratios and mean differences with 95% confidence intervals, we employed conventional and Bayesian network meta-analysis converted to surface under the cumulative ranking.

Results: A total of 49 studies with 31,105 patients were included in this review. HM3 is the best device exchange choice that causes the lowest risk of mortality (HM3 (99.98) > HM2 (32.43) > HVAD (17.58)), cerebrovascular accidents (HM3 (99.99) > HM2 (42.41) > HVAD (7.60)), other neurologic events beside cerebrovascular accident (HM3 (91.45) > HM2 (54.16) > HVAD (4.39)), pump thrombosis (HM3 (100.00) > HM2 (39.20) > HVAD (10.80)), and bleeding (HM3 (97.12) > HM2 (47.60) > HVAD (5.28)). HM3 is also better than HM2 in hospital admissions (OR: 1.90 (95% CI: 1.15-3.12)). When complications were present, HM2 or Heartware ventricular assist devices exchange to HM3 lowered the mortality rate compared to exchanging it to the same device type.

Conclusion: HM3 is the best device for all six outcomes. Exchange from Heartware ventricular assist devices or HM2 to HM3 rather than the same ventricular assist device type is recommended only if a complication is present.

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在晚期心力衰竭患者中，Heartware 心室辅助装置与 HeartMate II 和 HeartMate III 的比较：系统回顾和荟萃分析。

目的：心室辅助装置是心衰患者的治疗选择之一。因此，本综述旨在帮助临床决定是否将以前的旧型心室辅助装置更换为最新型的 HM3：在 2023 年 2 月 25 日之前，在多个数据库中进行了检索，注册 ID 为 CRD42023405367。使用 Cochrane Risk of Bias 2.0 和纽卡斯尔-渥太华量表进行偏倚风险分析。为了对汇集的几率比和均值差异及95%置信区间进行排序和评估，我们采用了传统的贝叶斯网络荟萃分析法，并将其转换为累积排序下的表面分析法：本综述共纳入了 49 项研究，31105 名患者。HM3 是最佳的设备交换选择，其导致的死亡率（HM3（99.98）> HM2（32.43）> HVAD（17.58））、脑血管意外（HM3（99.99）> HM2（42.41）> HVAD（7.60））、脑血管意外以外的其他神经事件（HM3（91.45）> HM2（54.16）> HVAD（4.39））、泵血栓（HM3（100.00）> HM2（39.20）> HVAD（10.80））和出血（HM3（97.12）> HM2（47.60）> HVAD（5.28））。在入院率方面，HM3 也优于 HM2（OR：1.90（95% CI：1.15-3.12））。当出现并发症时，将HM2或Heartware心室辅助装置更换为HM3与更换为相同类型的装置相比，死亡率更低：结论：就所有六种结果而言，HM3 是最佳设备。只有在出现并发症时，才建议将 Heartware 心室辅助装置或 HM2 换成 HM3，而不是换成相同类型的心室辅助装置。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

3.50

自引率

4.30%

发文量

289

审稿时长

12 weeks