Advanced Heart Failure Patients Should Have Option of LVAD Device Interview with:
Amrut V. Ambardekar, MD
Medical Director Cardiac Transplant Program
Division of Cardiology, Section of Advanced Heart Failure-Transplant Cardiology
University of Colorado What is the background for this study? What are the main findings?

Response: As left ventricular assist device (LVAD) technology has improved, the appropriate timing for implant of these devices (essential a form of an artificial heart pump) in patients with advanced heart failure is unknown.

The goal of the MedaMACS study was to describe the prognosis of a group of patients with advanced heart failure who currently do not require intravenous therapies, and determine how they compare to a similar group of patients who received a LVAD.

The main finding from this study is that the “sickest” group of patients with advanced heart failure on oral medical therapy (known as INTERMACS profile 4 patients) have very poor outcomes with a strong trend for improvement in survival with LVAD therapy.

The other take home message is that among all of the patients enrolled in the study on medical therapy, only approximately half were alive after an average of 12 months of follow up without needing a heart transplant or LVAD placement. What should readers take away from your report?

Response: Patients with advanced heart failure who have been hospitalized are at high risk for poor outcomes including death and rehospitalization.  These patients should be seen at an Advanced Heart Failure-Transplant-LVAD center so they have the option to be considered for these advanced heart failure therapies. What recommendations do you have for future research as a result of this study?

Response: The mean follow up of this study was 12 months, so even longer follow up would be helpful.  In addition, as LVAD therapy continues to improve, it is possible the benefit of LVAD therapy may also allow for shifting utilization to an even less sick group of heart failure patients.  This would require further research.

No other disclosures Thank you for your contribution to the community.


ISHLT 2017 presentation 

Medical Arm of Mechanically Assisted Circulatory Support (MedaMACS) in Advanced Heart Failure

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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