Pregnancy and Delivery Care for a Patient With a HeartMate 3.
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2025-06
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Abstract
Background
The limited available data on pregnancies among patients with left ventricular assist devices (LVADs) in situ shows elevated rates of maternal and fetal/neonatal morbidity and mortality. The first fully magnetically levitated device providing centrifugal continuous flow, HeartMate 3 (HM3, Abbott), is the only LVAD available in the United States since 2018 and has fewer adverse patient outcomes compared with previous devices.Case summary
A 32-year-old G5P2113 woman became pregnant 19 months after destination-therapy HM3 LVAD placement. Uncomplicated antepartum care and a cesarean delivery at 34 weeks under neuraxial anesthesia was facilitated by our institution's pregnancy heart team.Discussion
This represents the second reported HM3-supported pregnancy resulting in a live birth. Various barriers to care guided a shared anticoagulation plan, and no hemorrhagic or thrombotic complications occurred. Our intrapartum monitoring strategy facilitated a patient-centered delivery and postpartum experience while maintaining excellent patient safety.Type
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Jones, Sara I, Heather Acuff, Ryan Best, Yen-Yen Gee, Sarah C Snow, Richa Agarwal, Karen Flores Rosario, Jennifer B Gilner, et al. (2025). Pregnancy and Delivery Care for a Patient With a HeartMate 3. JACC. Case reports, 30(13). p. 103536. 10.1016/j.jaccas.2025.103536 Retrieved from https://hdl.handle.net/10161/33441.
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Karen P. Flores Rosario
Jennifer B Gilner
As a clinician-scientist, I have built my career around the care of women throughout pregnancy, while simultaneously working to advance the scientific understanding of pregnancy complications such as preterm birth and placenta accreta spectrum.
I have advanced training in the medical and surgical care of women with pregnancies affected by medical conditions or pregnancy-related complications, as well as basic science expertise in immunology and tolerance mechanisms of pregnancy.
Jerome Jeffrey Federspiel
Dr. Federspiel is a maternal fetal medicine physician at Duke University. His clinical and research interests focus on the care of people with cardiovascular and hematologic complications of pregnancy.
Marie-Louise Meng
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.