{"id":"294a2b6c0282","type":"article","url":"https://hartvaat.nl/2018/04/12/heartmate-3-2-jaarsresultaten-bij-gevorderd-hartfalen-nejm-momentum-3/","title":"HeartMate 3 2-jaarsresultaten bij gevorderd hartfalen: NEJM MOMENTUM 3","title_en":"Two-Year Outcomes with a Magnetically Levitated Cardiac Pump in Heart Failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa1800866","source_url":"https://doi.org/10.1056/NEJMoa1800866","authors":["Mandeep R Mehra","Daniel J Goldstein","Nir Uriel","Joseph C Cleveland","Melana Yuzefpolskaya","Christopher Salerno","Mary N Walsh","Carmelo A Milano","Chetan B Patel","Gregory A Ewald","Akinobu Itoh","David Dean","Arun Krishnamoorthy","William G Cotts","Antone J Tatooles","Ulrich P Jorde","Brian A Bruckner","Jerry D Estep","Valluvan Jeevanandam","Gabriel Sayer","Douglas Horstmanshof","James W Long","Sanjeev Gulati","Eric R Skipper","John B O'Connell","Gerald Heatley","Poornima Sood","Yoshifumi Naka"],"significance":9,"published":"2018-04-12","source_date":"2018-04-12","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/lvad-ventrikelondersteunende-systemen/"],"congress":"","summary_en":"The 2-year MOMENTUM 3 results confirmed the sustained superiority of the HeartMate 3 magnetically levitated LVAD over the HeartMate II, with significantly fewer adverse events including pump thrombosis, stroke, and bleeding. The data cemented HeartMate 3 as the standard of care in mechanical circulatory support.","created":"2026-07-03T10:27:14Z","updated":"2026-07-03T13:26:29Z","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":"NEJM 2-jaarsresultaten van MOMENTUM 3 die de superioriteit van de HeartMate 3 LVAD bevestigen. Significant minder heropnames en pomptrombose dan eerdere generaties.","abstract_original":"BACKGROUND: In an early analysis of this trial, use of a magnetically levitated centrifugal continuous-flow circulatory pump was found to improve clinical outcomes, as compared with a mechanical-bearing axial continuous-flow pump, at 6 months in patients with advanced heart failure. METHODS: In a randomized noninferiority and superiority trial, we compared the centrifugal-flow pump with the axial-flow pump in patients with advanced heart failure, irrespective of the intended goal of support (bridge to transplantation or destination therapy). The composite primary end point was survival at 2 years free of disabling stroke (with disabling stroke indicated by a modified Rankin score of >3; scores range from 0 to 6, with higher scores indicating more severe disability) or survival free of reoperation to replace or remove a malfunctioning device. The noninferiority margin for the risk difference (centrifugal-flow pump group minus axial-flow pump group) was -10 percentage points. RESULTS: Of 366 patients, 190 were assigned to the centrifugal-flow pump group and 176 to the axial-flow pump group. In the intention-to-treat population, the primary end point occurred in 151 patients (79.5%) in the centrifugal-flow pump group, as compared with 106 (60.2%) in the axial-flow pump group (absolute difference, 19.2 percentage points; 95% lower confidence boundary, 9.8 percentage points [P<0.001 for noninferiority]; hazard ratio, 0.46; 95% confidence interval [CI], 0.31 to 0.69 [P<0.001 for superiority]). Reoperation for pump malfunction was less frequent in the centrifugal-flow pump group than in the axial-flow pump group (3 patients [1.6%] vs. 30 patients [17.0%]; hazard ratio, 0.08; 95% CI, 0.03 to 0.27; P<0.001). The rates of death and disabling stroke were similar in the two groups, but the overall rate of stroke was lower in the centrifugal-flow pump group than in the axial-flow pump group (10.1% vs. 19.2%; hazard ratio, 0.47; 95% CI, 0.27 to 0.84, P=0.02). CONCLUSIONS: In patients with advanced heart failure, a fully magnetically levitated centrifugal-flow pump was superior to a mechanical-bearing axial-flow pump with regard to survival free of disabling stroke or reoperation to replace or remove a malfunctioning device. (Funded by Abbott; MOMENTUM 3 ClinicalTrials.gov number, NCT02224755 .)."}