Abstract
BACKGROUND: The influence of inflow cannula (IC) direction in HeartMate 3 (HM3) remains unclear. We investigated preoperative anatomical characteristics related to IC direction by analyzing computed tomography (CT) images and assessed the relationship between prognosis and IC direction in HM3. METHODS: We evaluated 48 patients who underwent HM3 implantation and categorized them based on the IC direction: anterior/lateral wall (group A, n = 18), mitral/aortic valve (B, n = 21), and posterior/inferior wall (C, n = 9). In preoperative CT, the positional relationship between the mitral valve, left ventricle (LV) apex, chest wall, and diaphragm was evaluated. The survival rate and freedom rate from complications after HM3 implantation in each group were evaluated. RESULTS: On preoperative CT, group A had a higher mitral valve height from the LV apex than group B (68 ± 13 and 52 ± 14 mm, respectively; p < 0.01). Group C had a longer distance between the LV apex and chest wall than group B (20 ± 9 and 9 ± 6 mm, p < 0.01). Group C had a shorter thoracic depth from the LV apex than did group B (24 ± 9 and 39 ± 11 mm, p < 0.01). The 3-year survival rates after HM3 implantation for groups A, B, and C were 88%, 90%, and 100%, respectively. The rates of freedom from complications after HM3 implantation at 3 years in groups A, B, and C were 50%, 43%, and 20%, respectively. CONCLUSIONS: The IC direction in HM3 was influenced by the preoperative position of the mitral valve, LV apex, chest wall, and diaphragm. The IC direction in HM3 did not significantly affect survival rates.