Limited Value Found for First-Generation Heart Pumps

Nov. 26 -- TUESDAY, Nov. 25 (HealthDay News) -- The first generation of ventricular assist devices (VADs) -- tiny pumps implanted in people with failing hearts -- are costly but provide limited benefits, a study finds.

However, the finding should not affect current medical practice, because the devices it describes are already being replaced by second- and third-generation VADS that are far superior, one expert said.

The study, published in the Journal of the American Medical Association, used data on almost 3,000 people who had VADs installed in a Medicare program between 2000 and 2006. Half the VADs were implanted as a primary treatment for heart failure, which is a progressive decline in the heart's ability to pump blood. The other half of the devices were implanted after a bypass surgery.

Fifty-five percent of those in the primary treatment group were discharged alive from the hospital, with 42 percent of dying over the following year, the researchers found. In the post-surgery group, a third were discharged alive from the hospital, and one quarter were alive a year later.

The total cost for patients in the primary treatment group was nearly $200,000 per person, the team estimated. The price tag was about $100,000 for those in the post-bypass group.

Given the cost and the uncertainty as to outcomes, "we need better data so we can have predictive tools in terms of understanding which patients will be successful and those who are extremely unlikely to live long with a VAD," said study lead author Dr. Adrian F. Hernandez, assistant professor of medicine at the Duke Cardiovascular Research Institute in Durham, N.C.

That data will come from a registry that is being kept of all the people who receive VADs, Hernandez said. Meanwhile, he said, "we certainly need more clinical studies to find out what is the right window for offering a patient a VAD."

The registry that now is being maintained will provide the needed information, said Dr. John V. Conte, director of the heart transplant and cardiovascular circulatory support program at Johns Hopkins University, but the findings of the new study can safely be disregarded, anyway, he said.