{"id":"7beda83dd11c","type":"article","url":"https://hartvaat.nl/2017/02/02/volledig-magnetisch-zwevende-circulatoire-pomp-bij-gevorderd-hartfalen-nejm-mome/","title":"Volledig magnetisch zwevende circulatoire pomp bij gevorderd hartfalen: NEJM MOMENTUM 3","title_en":"A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["pathfinder-trial"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa1610426","source_url":"https://doi.org/10.1056/NEJMoa1610426","authors":["Mandeep R Mehra","Yoshifumi Naka","Nir Uriel","Daniel J Goldstein","Joseph C Cleveland","Paolo C Colombo","Mary N Walsh","Carmelo A Milano","Chetan B Patel","Ulrich P Jorde","Francis D Pagani","Keith D Aaronson","David A Dean","Kelly McCants","Akinobu Itoh","Gregory A Ewald","Douglas Horstmanshof","James W Long","Christopher Salerno"],"significance":10,"published":"2017-02-02","source_date":"2017-02-02","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/lvad-ventrikelondersteunende-systemen/"],"congress":"","summary_en":"The MOMENTUM 3 trial demonstrated that the HeartMate 3, a fully magnetically levitated centrifugal-flow LVAD, was superior to the axial-flow HeartMate II in patients with advanced heart failure, with significantly fewer pump thrombosis events and reoperation. This established the HeartMate 3 as the standard of care in mechanical circulatory support.","created":"2026-07-03T10:26:33Z","updated":"2026-07-03T13:25:51Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Landmark NEJM MOMENTUM 3-trial van de HeartMate 3 LVAD — volledig magnetisch zwevende pomp bij gevorderd hartfalen. Superieur aan eerdere generaties met significant minder pomptrombose.","abstract_original":"BACKGROUND: Continuous-flow left ventricular assist systems increase the rate of survival among patients with advanced heart failure but are associated with the development of pump thrombosis. We investigated the effects of a new magnetically levitated centrifugal continuous-flow pump that was engineered to avert thrombosis. METHODS: We randomly assigned patients with advanced heart failure to receive either the new centrifugal continuous-flow pump or a commercially available axial continuous-flow pump. Patients could be enrolled irrespective of the intended goal of pump support (bridge to transplantation or destination therapy). The primary end point was a composite of survival free of disabling stroke (with disabling stroke indicated by a modified Rankin score >3; scores range from 0 to 6, with higher scores indicating more severe disability) or survival free of reoperation to replace or remove the device at 6 months after implantation. The trial was powered for noninferiority testing of the primary end point (noninferiority margin, -10 percentage points). RESULTS: Of 294 patients, 152 were assigned to the centrifugal-flow pump group and 142 to the axial-flow pump group. In the intention-to-treat population, the primary end point occurred in 131 patients (86.2%) in the centrifugal-flow pump group and in 109 (76.8%) in the axial-flow pump group (absolute difference, 9.4 percentage points; 95% lower confidence boundary, -2.1 [P<0.001 for noninferiority]; hazard ratio, 0.55; 95% confidence interval [CI], 0.32 to 0.95 [two-tailed P=0.04 for superiority]). There were no significant between-group differences in the rates of death or disabling stroke, but reoperation for pump malfunction was less frequent in the centrifugal-flow pump group than in the axial-flow pump group (1 [0.7%] vs. 11 [7.7%]; hazard ratio, 0.08; 95% CI, 0.01 to 0.60; P=0.002). Suspected or confirmed pump thrombosis occurred in no patients in the centrifugal-flow pump group and in 14 patients (10.1%) in the axial-flow pump group. CONCLUSIONS: Among patients with advanced heart failure, implantation of a fully magnetically levitated centrifugal-flow pump was associated with better outcomes at 6 months than was implantation of an axial-flow pump, primarily because of the lower rate of reoperation for pump malfunction. (Funded by St. Jude Medical; MOMENTUM 3 ClinicalTrials.gov number, NCT02224755 .)."}