# Heartmate 3 left ventricular assist device system in patients with glucose-6-phosphate dehydrogenase deficiency

## TL;DR

This study examines the safety of a heart pump device in patients with a genetic enzyme deficiency that causes red blood cell breakdown.

## Contribution

The study provides early evidence on the safety of Heartmate 3 LVADs in patients with G6PD deficiency, a previously understudied population.

## Key findings

- Five G6PD-deficient patients received LVADs without major complications during hospitalization.
- No macroscopic hemolysis occurred during follow-up despite the patients' condition.
- Two patients died, two devices were removed, and one received a heart transplant during follow-up.

## Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic enzymatic disorder that affects millions of people worldwide and characterized by hemolysis under oxidative stress. Left ventricular assist devices (LVADs) have substantially enhanced survival and quality of life for individuals with advanced heart failure. However, their use is associated with the risk of hemolysis, thrombosis, and embolic events. These risks may be heightened in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Given the limited published research on this subject, the primary objective of this study was to assess the degree of hemolysis and identify associated factors in adult patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency who underwent Heartmate 3 (HM3) left ventricular assist device (LVAD) implantation.

This retrospective, observational, single-center study was conducted on adult (>18 years of age) patients with G6PD deficiency, who underwent LVAD implantation using the HM3 LVAD between 2017 and 2022. Hemolysis-related investigation and findings as well as in-hospital outcome were assessed.

Left ventricular assist devices (LVADs) were successfully implanted in five adult patients with G6PD deficiency, including one individual with associated sickle cell trait (SCT). There were no major complications or fatalities during the hospitalization period. The average follow-up duration was 30 months (mean 30.4 ± 13). During the follow-up period, two patients died, two LVADs were explanted, and one patient received a heart transplant. No instances of macroscopic hemolysis were observed throughout the follow-up period.

While our study was limited in size, LVADs seem safe for G6PD-deficient patients and offer significant clinical benefits. Larger studies are needed to confirm this and assess long-term interactions.