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New Therapies may Help to Avoid Transplant in Some Heart Failure Patients

Implanted pumps improve heart function for some end-stage heart patients thereby allowing them to forgo heart transplantation, according to a study in the Journal of the American Heart Association.

The heart-assist devices also significantly improved the cardiac function in many other heart failure patients.

"This suggests that, while the devices alone may not be sufficient to allow a meaningful number of patients to come off the heart pump instead of having a heart transplant, there may be other therapies that can be added to enhance recovery," said Simon Maybaum, M.D., lead author of the study.

In end-stage heart failure, the heart weakens, gets larger and shows other signs of deterioration. Implantable heart pumps, called left ventricular assist devices (LVADs), pump blood through the body, which lets the hearts main pumping chamber rest. Pumps are currently approved for two purposes:

To help keep patients with end-stage heart failure alive until a donor heart becomes available for transplantation.
To serve as a long-term therapy for patients deemed unacceptable for a heart transplant.

However, for some time, transplant specialists have debated the potential for LVADs to be used as a "bridge to recovery" for the patients own heart. Prior small studies have yielded contrasting results. "Some centers were reporting that up to a third of their patients implanted with a heart pump were able to come off the pump without a transplant, and some centers were saying they just did not have that experience," said Maybaum, associate professor of clinical medicine and medical director of the Center for Advanced Cardiac Therapy at the Albert Einstein College of Medicines Montefiore Medical Center in New York City.

To resolve these inconsistent findings, researchers from seven major U.S. heart transplant centers formed the LVAD Working Group. They enrolled 67 patients with end-s
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