LVAD Types Explained: HeartMate III vs. HeartWare

LVAD Types Explained: HeartMate III vs. HeartWare

Being curious and asking questions is something we always do. And when it comes to important decisions like LVAD implantation, it is completely natural to have concerns. It could be one of the major decisions of your life, and everything after this may depend on this. Before anything happens, your doctor will decide if the LVAD is the right choice for you or not based on your current health. However, the final decision is always yours to make.

That said, you need to understand what an LVAD is. Its types, indications, how it works, its advantages, and disadvantages to make an informed decision. 

LVAD Overview:

An LVAD, or Left Ventricular Assistive Device, is a mechanical support device that helps the weakened heart pump blood and supply oxygen-rich blood to the whole body. Think of it as a backup system that works for your heart when it cannot keep up on its own. 

If you have some type of heart condition where your heart is no longer able to provide enough blood to the body, then your doctor may recommend an LVAD as part of your treatment plan. It’s not a one-size-fits-all plan, though. 

Let’s take a look at conditions one by one so you can better understand when and why an LVAD might be the right choice:

Destination Therapy:

If your overall health is not strong enough for a major surgery like a heart transplant, an LVAD might be recommended as a permanent solution, which is known as destination therapy. In simple words, your LVAD becomes your support for the rest of your life. And thanks to the medical innovations and advancements, patients are now fully living, more active lives than before. So, while it might sound scary at first, it is a powerful option that is improving both survival and your quality of life.

Bridge to Transplant:

Waiting for a heart donor can be a long process, sometimes months and even years. And your heart is not capable of supporting your life until then. So, it means your heart needs help. That is when an LVAD serves as a bridge to transplant. Think of it as a temporary solution until you get the right donor match who can give you a healthy heart. Once you get your transplant, the LVAD is removed, and your new heart will take over from there.

Bridge to Recovery: 

Sometimes, heart failure is caused by something temporary, like a sudden illness or injury, which your body can recover from. In such cases, LVAD is used until your heart recovers completely. The goal here is to give your heart some time to rest and heal. Once your heart regains its power to function on its own, the LVAD can be removed. What is important for you here is to understand that this plan is not for you if you have a terminal heart disease or if the heart damage is permanent.

Different LVAD types:

Just like there are different heart conditions, there are different LVAD types, and each is designed with unique features. Your doctor will choose the best device according to your individual needs. Let’s talk about each of them in detail:

Some of the different LVAD types are as follows:

• HeartWare LVAD (HVAD) 

• Heartmate 2 LVAD

• Heartmate 3 LVAD

HeartWare LVAD (HVAD):

The HeartWare device was designed to help patients with heart failure by delivering a continuous, centrifugal blood flow. This pump spins at about 2500 to 3000 revolutions per minute and provides a blood supply with a rate of 10 liters per minute. 

This type of LVAD was small, lightweight, and was a popular choice at one time. But know that this type is no longer suitable to implant in your heart due to safety concerns. If you already have a HeartWare device, don’t need to worry; your medical team knows exactly how to manage it. 

Advantages:

• Compact design and does not require an abdominal pump pouch

• Involves small incisions, which means you will need a short time for recovery

• Worked well for both destination therapy and bridge to transplant

Disadvantages:

• Higher chances for brain hemorrhage

• The pumping action also increases the risk of clot formation

Heartmate 2 LVAD:

Next up is Heartmate 2, an LVAD device that provides an axial flow of blood at high speed with no pulsatile action. This device is implanted in your heart, which improves the flow system in the heart. It is the type of LVAD that has been widely used in a variety of patients.

Advantages:

• Offers both reliability and durability

• Suitable for both children and adults

• Suitable for both short-term and long-term goals

Disadvantages:

• This device is more prone to mechanical wear

• Have fewer chances of blood clot formation as compared to HeartWare, but still have a significant risk

• You may face difficulty in measuring pulse rate or blood pressure 

• Associated with a risk of bleeding

Heartmate 3 LVAD:

Now comes HeartMate 3, which is the latest and greatest in LVAD technology. A fully magnetic device that provides a centrifugal flow of blood with a more natural pulsatile action. It is designed to reduce friction. It consists of a control system that constantly monitors the functioning of the implanted LVAD and lets you know about alarming situations. It is implanted in the chest cavity and allows greater perfusion of blood throughout the body. 

Advantages:

• Fewer chances of blood clots and brain hemorrhage

• Pulse-like flow of this LVAD pump supports blood flow and vascular health

• Highly recommended for short-term therapy and bridge to transplant

Disadvantages:

• Device too large for pediatric patients

• Usually more expensive compared to other devices

• Need larger incisions to implant surgically

What is the difference between HeartMate III and HeartWare? 

HeartMate 3 and HeartWare HVAD are both LVAD types used to help patients with severe heart failure, but they are pretty different in reality. HeartMate 3 uses a newer technology with a fully magnetically ascended pump, which means fewer risks and smoother blood flow due to an artificial pulse design that has reduced friction. 

In contrast, HeartWare is smaller and easier to implant, but it came with higher stroke risks and was eventually taken off the market in many countries due to safety concerns. Know more with the guide: LVAD Device Explained: Benefits, Risks, and Recovery.

HeartMate III or HeartWare: Which is good?

According to the study conducted on both HeartMate and HeartWare surgical outcomes, in 2024, patients who received the HeartMate 3 were generally in better condition before surgery, and they were less likely to need ventilator support. 

However, people with the HeartMate 3 had fewer serious strokes later on. In short, while both devices worked well overall, the HeartMate 3 showed some safety advantages after surgery, so HeartMate 3 is now the preferred option.  

Living with an LVAD

Life after an LVAD is completely different from what you ever imagined. But it does not mean you just have to adjust to it just for living. LVADGear has made life easier, comfortable, and active with their products like LVAD vests, LVAD bags, and LVAD accessories for both HeartMate and HeartWare devices.

While you are still adjusting to your new life, the right choice for clothing and accessories can help you feel like yourself again.

Conclusion

LVAD types are of different generations and offer different advantages and disadvantages, but your healthcare provider will choose the best type according to your suitability, general health, and cost of the treatment. 

FAQs

What is the latest LVAD version?

The most advanced type of LVAD is HeartMate 3, which offers improvement in blood flow without causing complications like blood clot formation and stroke.

Is LVAD a second name for Impella?

No, Impella is a type of LVAD, but it is just a temporary support that is inserted into your heart through a catheter without any open heart surgery. On the other hand, LVAD is implanted in your heart through a major surgery and provides long-term support. 

What are the indications of LVAD?

Patients with heart failure are usually candidates for LVAD implantation. People who are waiting for a healthy donor heart or need lifelong support can benefit from an LVAD device.