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Implantable pumps extend lives of patients too sick for transplant

Pumps implanted into the chest to maintain circulation can significantly extend the lives of the sickest patients in end-stage heart failure who are not candidates for heart transplantation, according to the results of a clinical trial led by Duke University Medical Center cardiologists.

The pumps, known as left ventricular assistant devices (LVADs), are employed when the heart's left ventricle ?the chamber of the heart that pumps blood throughout the body ?is too weak to pump enough blood to nourish the body's tissues. LVADs have been used as successful short-term "bridges to heart transplant" and are increasingly being considered as a long-term heart failure destination therapy, said the researchers.

In the current trial, the researchers found that patients who received LVADs had an average survival time of 10.3 months, compared to 3.1 months for those who did not receive the device. In this group of end-stage heart failure patients, 78 percent died within six months and 90 percent within a year.

"The patients who received the devices not only had a lengthened quantity of life, but they appeared to have an improved quality of life," said Duke cardiologist Joseph Rogers, M.D., who presented the results of the trial Nov. 14, 2005, at the annual scientific session of the American Heart Association meeting in Dallas. "We had patients who were doing the normal activities of life, such driving cars, fishing and golfing."

Patients who were on the LVADs scored significantly higher on standard measures of quality of life than patients in the control group, Rogers said.

"This is a remarkably ill group of patients," Rogers continued. "When you look at the control group, which was receiving the best care medicine has to offer, we can only keep ten percent of them alive after one year. We need to focus on this as a group of patients, since most are still in the prime of life and can still be quite productive."

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Source:Duke University Medical Center


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