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(Circulation. 2007;116:461-462.)
© 2007 American Heart Association, Inc.

Editorial

Mechanical Circulatory Support

New Data, Old Problems

Sharon A. Hunt, MD

From Cardiovascular Medicine, Stanford University Medical Center, Palo Alto, Calif.

Correspondence to Sharon A. Hunt, MD, Professor, Cardiovascular Medicine, 300 Pasteur Dr/CVRB, Palo Alto, CA 94305. E-mail hunts@leland.stanford.edu

Key Words: Editorials • heart-assist device • transplantation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Mechanical devices to support the circulation in the presence of a "failing" heart were originally conceived as alternatives to biological replacement of the heart. Such alternatives are needed because of the problems inherent in allotransplantation. These have included the grossly inadequate supply of donor hearts, as well as the need for chronic immunosuppression and the myriad of complications attendant on its use. Thus far, however, such devices have been employed primarily as "bridges" to extend the survival of desperately ill patients until an appropriate donor heart becomes available. Although such use has been a productive endeavor in terms of gaining experience with the devices and prolonging some lives that would otherwise have been lost before a donor became available, it has not increased the numbers of donors and has simply shifted the population of those who receive donor hearts to include sicker patients. The rare use of a mechanical device to provide temporary support as a bridge to myocardial recovery from some original insult deserves note but thus far appears to involve very small numbers of patients.^1,2

Article p 497

The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study, published in 2001,³ was the first and is still the only randomized, controlled study to compare the use of permanent or "destination" mechanical circulatory support (left ventricular assist device, or LVAD, and the specific model called the HeartMate vented electric device, from Thoratec Corp, Pleasanton, Calif) with optimum medical therapy for a group of transplant-ineligible . . . [Full Text of this Article]

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