Early Use of Ventricular Assist Devices Saves Lives

Ventricular assist devices (VADs) should be implanted before the occurrence of profound cardiogenic shock, according to doctors at the German Heart Institute (Berlin), based on their extensive experience using these devices. Their finding was presented at the annual congress of the European Society of Cardiology in Berlin (Germany).

They found that only 45% of patients who received the devices after the occurrence of profound cardiogenic shock survived to 30 days, compared with 72% who received the devices without cardiogenic shock. This means that patients with severe end-stage heart failure should be considered for implantation of an assist device before cardiogenic shock occurs.

Implantation of left ventricular assist devices (LVADs) began in 1994 and now accounts for almost 70% of the institute's total number of procedures. Doctors found that there was no significant difference in long-term survival after heart transplantation in patients with and without previous ventricular device support. In about 30% of patients with dilative cardiomopathy treated with an LVAD, recovery of the patient's own heart was observed and the device was later explanted. To date, the device has been explanted in more than 30 patients.

Newer devices, such as axial flow pumps, can increase a patient's quality of life, since they are smaller and lighter than the older devices and can be implanted easily in the mediastinum or pleural space. A new small axial-flow assist device, developed and manufactured by the Berlin Heart AG in cooperation with the German Heart Institute, was implanted in the first two patients this summer. Both the longevity and quality of life of older patients with end-stage heart failure can be increased using such assist devices as a definitive therapy, say doctors at the institute. Currently, 23 patients are on mechanical support, of which 11 are expected to need the VAD permanently.



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German Heart Institute