Heartfelt with Dr Melissa Walton-ShirleyView all posts »
LVADS work: Why the US must pump up the volume for the HeartMate IINov 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.