August 29, 2007 (Insidermedicine) Patients who are awaiting heart transplant surgery may be able  to buy time with  a continuous-flow left  ventricular assist device,  say experts in a report published in the New England Journal of Medicine.    

Patients with severe heart failure not responding to  conventional treatment of acute  heart failure  should be  considered as  potential candidates for mechanical support. 

Patients with  potential recovery  of cardiac  function should  be considered as candidates for ventricular assist devices    And  patients  with  permanent  end-organ  dysfunction,  including severe systemic  disease,  severe renal  failure,  pulmonary  disease, hepatic dysfunction, or permanent central nervous injury are generally not considered for device therapy.    

Each year,  about  56,000 Americans  could  benefit from  a  heart transplant. However, because of the  shortage of donated hearts,  many people who need a  heart transplant die while  waiting. Some of  these candidates could potentially  benefit from having  a left  ventricular assist device or LVAD - implanted to  buy time until a donor heart  is available. Although the first of these devices developed 25 years  ago were heavy and bulky, newer  continuous-flow pumps are more  reliable, quieter, and smaller.

In the present study, researchers  studied just over 130  patients with end-stage heart failure who were awaiting heart  transplantation. The patients had a continuous-flow  pump implanted in their chest  and were assessed for quality of life and exercise endurance at the  start of the study, and one, three, and six months thereafter.

The survival rate during support was 75% at six months and 68% at one  year.  Most  patients  experienced  significant  improvement in functional status and quality  of life. Complications associated  with the use of the device included post-operative bleeding, stroke,  right heart failure, pump thrombosis, and infection.

If you have a patient who could potentially benefit from having  a continuous-flow pump implanted, find out if  he or she is a  candidate for one of the on-going clinical trials.

Reporting for Insidermedicine In Depth, I'm Dr. Susan Sharma.