Retrospective hemolysis comparison between patients with centrifugal biventricular assist and left ventricular assist devices

Little is known about the hemolysis rate in the case of concomitant implantation of two continuous flow pumps for the treatment of biventricular heart failure. We present a retrospective study comparing the hemolysis parameters in patients supported with one implantable centrifugal pump of the type HeartWare HVAD employed as a left ventricular assist device (LVAD) and with two pumps as a biventricular assist device (BiVAD). A total of 20 consecutive patients who received HeartWare BiVAD (n=10) and LVAD (n=10) support at our institution between September 2009 and September 2010 were examined. Hemolysis- and anemia-related parameters were analyzed after 2 weeks, 5 weeks, 3 months and 6 months of support. Preoperative levels of hemoglobin, LDH and total bilirubin were similar in both groups. There were no differences in LDH, fHB or total bilirubin levels postoperatively for up to 6 months. Only the haptoglobin level was lower in BiVAD recipients up to 3 months after surgery: second week (63.5 (range 8-237) mg/dl vs. 151 (range 11-263) mg/dl, p=0.05), 5th week (67 (range 8-196) mg/dl vs. 215 ( range 56-292) mg/dl, p=0.046), after 3rd month (42 (range 8-205) mg/dl vs. 220 (range 157-256) mg/dl, p=0.048). Our retrospective analysis of BiVAD HeartWare and LVAD HeartWare recipients showed a lack of a clinically important degree of hemolysis when two centrifugal HeartWare pumps are used for biventricular support.