LVAD
AMBASSADORS
The study of 50 heart transplant candidates, found that survival rates among those implanted with the 5-oz HeartWare ventricular assist system were 90% at six months, 84% at one year, and 79% at two years, Martin Strueber, MD, of Hannover Medical School in Germany, and colleagues reported in the Journal of the American College of Cardiology.
"The results of this study indicate that patients with severe heart failure can be bridged to heart transplant with a small, levitated continuous-flow LVAD that is implanted within the pericardial space and that provides full circulatory support," Strueber and co-authors concluded.
Since the effectiveness of heart transplants and medical therapy are limited, more physicians have been turning to mechanical circulatory support as a primary treatment for end-stage heart disease. The devices can be used either as a bridge to transplant or, in some cases, as destination therapy -- as was the case with former vice president Dick Cheney.
The HeartWare device is among the smaller, third-generation LVAD devices, which include the HeartMate II and the DuraHeart (both of which are around the same size at about 10 oz).
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The HeartWare device can be placed within the pericardial space, which eliminates the need for abdominal surgery and the creation of a pump pocket, the researchers noted.
As with the other third-generation LVADs, HeartWare uses continuous flow technology, rather than the pulsatile pump design of earlier devices. To assess the efficacy of the HeartWare as bridge-to-transplant therapy, the researchers enrolled 50 heart transplant candidates with New York Heart Association class IV symptoms at five medical centers in Europe and Australia from March 2006 to December 2008. The patients were supported by the LVAD until transplant, myocardial recovery and device explant, or death.
The majority of the patients -- 86% -- were male, with a mean age of 48.5 and ranging from 20 to 75.