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Racing as a Way of Life

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Evgenij Potapov, MD, PhD
Deutsches Herzzentrum
Berlin, Germany

Almost four years ago (see here), I dreamed about a competition between the ventricular assist devices that were commercially available at the time. Now Abbot (previously Thoratec) has carried out a comparison between HeartMate 2 and HeartMate 3.

The study shows that the new technology is not worse than the old. But is it better? So far it seems that the new system produces less pump thrombosis, while overall early survival remains similar. However, the study is still running and it may discover some survival advantages for the HeartMate 3 during the long-term follow-up.

This study, although meticulously conducted, compared two pumps from the same company and, moreover, let technology from the past century run against the new one. No real competition. And, to be honest, the time for HeartMate 2 is gone, with or without long-term results.

Further development of the HeartMate 3 is currently underway, to create a smaller pump, correct the position of the metal part of the outflow tract and modify other features.

The main question today remains the comparison between the two most frequently implanted pumps - HeartMate 3 and the HeartWare HVAD. My personal impression after one year of implanting both pumps is that the two pumps, although having different complication profiles, are similar in short-term outcome.

The most intriguing question for the near future is the clinical use of transcutaneous energy and data transfer.

In my personal opinion, the company which introduces this option first would gain the increased attention of surgeons, referring cardiologists and, most importantly, of patients, as long as the performance of the pump itself equaled that of the existing pumps.

I hope that the race for TET between the major players in the field will be accelerated, since both companies now, after acquisition, have enormous experience with similar technology. However, one of the smaller companies may be set to overtake them and may come up with a solution in the near future.

I also hope that readers of ISHLT Links will take the time to react to this piece and to send me by email their comments, which we will discuss during the next ISHLT meeting. ■

Disclosure Statement: The author has no conflicts of interest to disclose.

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