Ventricular assist devices not yet suitable for all with heart failure

Reported by Susan Aldridge, PhD, medical journalist

A review suggests the use of ventricular assist devices to help people with heart failure should continue to be limited.
A ventricular assist device (VAD) is an implantable pump which can support the failing heart. In Britain, the VAD has been used as a 'bridge' to heart transplant for patients desperately sick with heart failure who are awaiting a new organ. The UK's National Institute for Health Research now reports upon the use of this device among 70 patients in the UK.

In all 70 cases, the VAD was being used as a bridge to a heart transplant. Thirty of them died before receiving a donor heart. Of those who survived, the VAD did improve heart function - but not as much as a heart transplant. The patients must stay in the hospital all the time they have the VAD, which limits quality of life.

When it comes to costs, the VAD is expensive - about 116,000 dollars for the operation and another 26,000 dollars on average for the hospital stay. Transplant candidates without a VAD consumed far less in terms of resources as well as having better survival rates. But the VAD patients did have a survival rate of 52 per cent after a year, which the researchers call an 'excellent clinical achievement'. They recommend the VAD continue to be used in selected patients. But the technology needs further development before it can be more widely applied to patients with heart failure. Research is underway into VADs which can be used as a more permanent support to the failing heart.

Source
Health Technology Assessment 2006 Volume 48 Number 10