# HeartMate 3 LVAD — definitief rapport: NEJM MOMENTUM 3 final

*geplaatst 2019-04-25 · Hartfalen · The New England journal of medicine · doi 10.1056/NEJMoa1900486 · https://hartvaat.nl/2019/04/25/heartmate-3-lvad-definitief-rapport-nejm-momentum-3-final/*

NEJM MOMENTUM 3 definitief rapport van de HeartMate 3 volledig magnetisch zwevende LVAD. Bevestigt de langetermijnsuperioriteit over HeartMate II.

## English: A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report.

The final MOMENTUM 3 report confirmed the long-term superiority of the HeartMate 3 fully magnetically levitated LVAD over the HeartMate II, with sustained reductions in pump thrombosis, stroke, and reoperations. The data cemented HeartMate 3 as the definitive standard in mechanical circulatory support.

## Abstract (original, from the publication)

BACKGROUND: In two interim analyses of this trial, patients with advanced heart failure who were treated with a fully magnetically levitated centrifugal-flow left ventricular assist device were less likely to have pump thrombosis or nondisabling stroke than were patients treated with a mechanical-bearing axial-flow left ventricular assist device. METHODS: We randomly assigned patients with advanced heart failure to receive either the centrifugal-flow pump or the axial-flow pump irrespective of the intended goal of use (bridge to transplantation or destination therapy). The composite primary end point was survival at 2 years free of disabling stroke or reoperation to replace or remove a malfunctioning device. The principal secondary end point was pump replacement at 2 years. RESULTS: This final analysis included 1028 enrolled patients: 516 in the centrifugal-flow pump group and 512 in the axial-flow pump group. In the analysis of the primary end point, 397 patients (76.9%) in the centrifugal-flow pump group, as compared with 332 (64.8%) in the axial-flow pump group, remained alive and free of disabling stroke or reoperation to replace or remove a malfunctioning device at 2 years (relative risk, 0.84; 95% confidence interval [CI], 0.78 to 0.91; P<0.001 for superiority). Pump replacement was less common in the centrifugal-flow pump group than in the axial-flow pump group (12 patients [2.3%] vs. 57 patients [11.3%]; relative risk, 0.21; 95% CI, 0.11 to 0.38; P<0.001). The numbers of events per patient-year for stroke of any severity, major bleeding, and gastrointestinal hemorrhage were lower in the centrifugal-flow pump group than in the axial-flow pump group. CONCLUSIONS: Among patients with advanced heart failure, a fully magnetically levitated centrifugal-flow left ventricular assist device was associated with less frequent need for pump replacement than an axial-flow device and was superior with respect to survival free of disabling stroke or reoperation to replace or remove a malfunctioning device. (Funded by Abbott; MOMENTUM 3 ClinicalTrials.gov number, NCT02224755.).

Auteurs: Mandeep R Mehra, Nir Uriel, Yoshifumi Naka, Joseph C Cleveland, Melana Yuzefpolskaya, Christopher T Salerno, Mary N Walsh, Carmelo A Milano, Chetan B Patel, Steven W Hutchins, John Ransom, Gregory A Ewald, Akinobu Itoh, Nirav Y Raval, Scott C Silvestry, Rebecca Cogswell, Ranjit John, Arvind Bhimaraj, Brian A Bruckner, Brian D Lowes, John Y Um, Valluvan Jeevanandam, Gabriel Sayer, Abeel A Mangi, Ezequiel J Molina, Farooq Sheikh, Keith Aaronson, Francis D Pagani, William G Cotts, Antone J Tatooles, Ashok Babu, Don Chomsky, Jason N Katz, Paul B Tessmann, David Dean, Arun Krishnamoorthy, Joyce Chuang, Ia Topuria, Poornima Sood, Daniel J Goldstein

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Bron: The New England journal of medicine, https://doi.org/10.1056/NEJMoa1900486. Bijgewerkt 2026-07-03T13:27:06Z. 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.