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tic procedures (11 percent). The time LVAD or organ transplant patients in the middle two quartiles spent in the hospital ranged from 16 to 55 days. These patients represent the type of person most likely to receive an LVAD in the future, say the researchers. Several factors predicted how long patients would stay in the hospital. For example, patients who developed general or device-related infections tended to have longer hospital stays. The infection rate can be reduced, Oz says, which would lower the procedure's cost.

"The major implication of this study is that we have a life-saving technology that is going to be expensive to deliver," he says. "The question we have to address as a society is whether it is worth the expense to put these devices in patients. Our study tells us that these costs are comparable to heart transplantation and liver transplantation ($205,000 and $250,000), which society is already willing to pay for.

"The costs, from my perspective, are less than many would have expected at such an early stage with a device like this," Oz says. "Improving management of these critically ill patients will substantially reduce the costs of this evolving technology."

The patients in REMATCH had the most severe form of CHF. They had also been dependent on heart-stimulating drugs to keep them alive within the prior three months, had a history of hospitalizations for their disease, and were ineligible for a heart transplant because of age, a previous cancer or other conditions unrelated to their heart.

The three-year, randomized trial compared 68 LVAD patients to 61 patients who received the optimal medical care available for CHF. Researchers reported at the American Heart Association's Scientific Sessions last year that the probability of one-year survival for those in the LVAD group was 52 percent vs. 25 percent for patients treated with medication only. Two-year survival rates were 23 percent for those with LVADs and 8
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
19-Nov-2002

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