J Cardiothorac Surg. 2026 Jun 6. doi: 10.1186/s13019-026-04331-2. Online ahead of print.
ABSTRACT
Heart failure (HF) affects over 64 million people worldwide, with prevalence projected to reach 3% by 2030. In advanced stages, when medical therapy fails and transplantation is limited by organ shortages, left ventricular assist devices (LVADs) represent a viable alternative. This retrospective, single-center study reports 10-year outcomes from the first Chilean LVAD program using the HeartWare (HVAD) device. Between 2013 and 2015, nine patients with advanced HF received HVAD implants. The mean age was 42.2 ± 15.8 years, with a left ventricular ejection fraction of 22% ± 4.1%. One-year survival was 77.8%, and 10-year survival for those using LVAD as destination therapy was 62.2%. All patients experienced at least one infection, with driveline infections being most common (55.5%). Bleeding events affected 77.7%, including gastrointestinal bleeding and severe epistaxis (both 22.2%). Neurological complications occurred in 33.3% of patients. Despite these events, four patients remained on LVAD support after 10 years, with no mechanical device failures requiring replacement. This case series highlights the feasibility, durability, and clinical relevance of long-term LVAD support in low-donation settings. Findings support LVADs as a destination therapy in selected patients and emphasize the importance of multidisciplinary care and structured follow-up.
PMID:42251323 | DOI:10.1186/s13019-026-04331-2