Left ventricular assist devices (LVADs), or mechanical cardiac pumps, are among the newest treatment options for congestive heart failure, which occurs when the heart can no longer pump enough blood to the body's organs. Traditionally, doctors treat these patients with medications that strengthen the heart's pumping ability or, when symptoms are life-threatening, with heart transplantation. LVADs perform the mechanical work of the heart when medications fail. They're implanted in the abdomen and attached to the left ventricle and the main blood vessel carrying blood from the heart to the body. A tube connects the pump to an external controller and power supply that are worn outside the body.
"We wanted to assess the impact of the Novacor LVAD in the treatment of patients with end-stage heart failure, who were not candidates for transplantation," said Joseph G. Rogers, M.D., lead author of the study and associate professor of medicine and medical director of the Cardiac Transplant and Mechanical Circulatory Support Program at Duke University School of Medicine in Durham, N.C.
Researchers studied 55 patients with the worst possible heart failure symptoms, including shortness of breath and fluid buildup in the body, who required intravenous medications to stay alive. In the non-randomized study, 18 patients were given intravenous medications, while 37 received an LVAD. Patients at the start of the study had an average 14 percent ejection fraction (EF), the measure of heart contractility. Normal EF is between 55 percent and 60 percent.
The researchers studied the patients for the remainder of their lives. They found that those with end-stage heart failure who were treated with only medications had a remarkably poor prognos
Contact: Carole Bullock or Karen Astle
American Heart Association