November 14th, 2010
New LVAD Shows Promise as Bridge-to-Transplant
Larry Husten, PHD
ADVANCE (Evaluation of the HeartWare HVAD Left Ventricular Assist Device System for the Treatment of Advanced Heart Failure) evaluated the clinical efficacy of a novel small centrifugal flow pump as a bridge-to-transplant. In the trial, 140 patients who received the device were compared to a contemporaneous control group of 499 similar patients who had received a commercially available LVAD as a bridge-to-transplant. Results of ADVANCE were presented on Sunday at the AHA meeting in Chicago.
At 180 days, 92% of HVAD patients were alive, had received a transplant, or had recovered and no longer needed the device, compared to 90% of controls. This result met the predefined test for noninferiority (P<0.001). The 1-year survival rate was 91% in the HVAD group compared to 86% in the controls.
Compared to baseline, HVAD-treated patients were able to walk farther (113 meters) and had significant improvements in several quality-of-life measures. The investigators reported that the HVAD had a favorable adverse event profile when used as a bridge-to-transplant and that “large quality of life and functional capacity improvements are similar to those obtained with cardiac transplantation.”
It would be interesting to learn about the immunogenicity profile of this VAD and the anticoagulation requirements.
Smaller VADs seem to be a great advantage to the patients.
Competing interests pertaining specifically to this post, comment, or both:
none