Heartfelt with Dr Melissa Walton-Shirley

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LVADS work: Why the US must pump up the volume for the HeartMate II

Nov 17, 2009 14:42 EST


If I gave you an opportunity to pick whether you could have an 8% chance or a 58% chance to survive for the next two years, how long would it take you to consider it? If the FDA approves the HeartMate II device, the 58% chance will become a reality for many.
 
Most heart-failure specialists tell us that incurring a diagnosis of end-stage congestive heart failure is more quickly lethal than receiving a diagnosis of most forms of cancer. With a cancer diagnosis, there might be some proven medical or surgical option in hope of a cure or palliation. Historically, 38% of class 3 and class 4 heart failure patients are dead in 38 months; 77% require repeat hospitalization for "all causes" within one year; and 33% are hospitalized for worsening heart failure within 12 months. With this new LVAD information, class 3 and 4 congestive heart failure patients finally have hope for both improved quantity as well as quality of life.

I've personally witnessed the LVAD transformation of the dying heart failure patient. I've seen the crimson-eared, tachypneic, hypotensive, cold victim with low urine output and no hope resurrect into the pink, smiling, warm, normal-appearing human being with an 8 AM tee-time and a hair appointment at 4 o'clock. I've seen life given back where there was little and quality given back where there was none. Equally as important in this economic environment, it makes perfect sense for the FDA to approve the HeartMate II for the 70 000 people who are waiting to die a preventable and costly death.

Dr Mark Slaughter, chief of cardiothoracic surgery at the University of Louisville hospital and the senior author of today's HeartMate II Destination Therapy Clinical Trial, attended the presentation by Dr Joseph Rogers of Duke. Dr Slaughter was later interviewed stating that an annual expenditure of "$30 billion for heart-failure treatment" is substantial and deserves examination. "Around $180 000 to $200 000 US dollars are spent per person on the last 12- to 4 months of their lives for heart failure care." It's not difficult to see that LVADs could not only be a humane solution but a cost-effective therapy as well. Although, Dr Slaughter was careful to add, further studies would need to be performed to precisely evaluate the impact of the cost-effectiveness of LVAD therapy.

For the patients who are living today because of either bridging or destination therapy and the patients who took the chance with the Abiocor that failed, I feel compelled to spread the good news of the HeartMate II study so that patients dying of heart failure might have a chance at life . . . or, more aptly put, a chance at really living.

See:

HeartMate II continuous-flow VAD sets new benchmark in destination-therapy trial





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Your comments
LVADS work: Why the US must pump up the volume for the HeartMate II
# 1 of 2
February 15, 2010 07:41 (EST)
Melissa
In 2009 I was diagnosed with cardiomyopathy and congestive heart failure at the age of 31. My EF was less than 15%. I progressed to end stage heart failure within a month and spent most of my summer in the hospital. In August 2009 they inserted the Heartmate II. I had the transformation you are talking about in your post. I went from having days to live and spending my life in the hospital, to being able to live again. However, I did have several complications with the LVAD and still spent quite a bit of time in the hospital. In December 2009 I was placed at the top of the transplant list. January 11 they found a heart for me and prepped me for surgery. Before completing the transplant, they did a TEE and found my EF had improved to 45%! Of course they didn't do the transplant and are making plans to have the pump removed. I posted this comment to also suggest that not only does the heart pump give hope of a better life, but perhaps in a few cases, it will actually help the heart to heal itself, as it did in my case. :-)
# 2 of 2
March 19, 2010 10:11 (EDT)
Melissa

Melissa,

So glad to hear you did so well.  There are many examples now of improved EF after the heart has been "rested" with the LVAD.  I wish you good health and many years of happy living!! Thanks for sharing!!

Another Melissa!


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About Dr Melissa Walton-Shirley
Dr Walton-Shirley performs invasive cardiology, nuclear cardiology, and stress echocardiography in a private practice in Glasgow, KY.

Her chief medical interests are CHF/hypertrophic obstructive cardiomyopathy and the promotion of primary PCI for acute MI. Recently she played a significant role in helping to launch an ambitious pilot study of primary PCI in Kentucky, the Kentucky Primary Angioplasty Pilot Project. She has also participated in the TIMI 19, Duke-HF, NRMI, and CRUSADE trials and is proud to have been an advocate of the first smoke-free initiative in Kentucky (2011). She champions a smoke-free America.

Dr Walton-Shirley received her undergraduate degree at the University of Kentucky and went to medical school and did her residency and fellowship at the University of Louisville. She is married with two daughters. Her interests include singing, writing poetry and songs, fitness, and, of course, theheart.org.