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LV assistance has been proposed as permanent, or destination, therapy for patients with advanced heart failure who are not candidates for cardiac transplantation. Findings from the REMATCH trial (JW Cardiol Jan 11 2002) provided proof of concept for this approach, demonstrating improved survival in end-stage heart failure patients randomized to receive a pulsatile-flow LV assist device (LVAD) versus ongoing medical treatment. However, survival in the LVAD group was limited by device complications, including stroke, infection, and the need for reoperation. In a manufacturer-sponsored, randomized controlled trial, investigators compared an FDA-approved pulsatile-flow LVAD with a second-generation, investigational continuous-flow LVAD.
Two hund…