Mandeep R. Mehra, MD, MSc, FRCP (London)The William Harvey Distinguished Chair in Advanced Cardiovascular MedicineMedical Director, Heart and Vascular Center, Brigham and Women’s HospitalExecutive Director, Center for Advanced Heart DiseaseBrigham and Women’s HospitalProfessor of Medicine, Harvard Medical School

Newer Heart Pumps Help Patients Even If They Are Not Eligible for Heart Transplant

MedicalResearch.com Interview with:

Mandeep R. Mehra, MD, MSc, FRCP (London)The William Harvey Distinguished Chair in Advanced Cardiovascular MedicineMedical Director, Heart and Vascular Center, Brigham and Women’s HospitalExecutive Director, Center for Advanced Heart DiseaseBrigham and Women’s HospitalProfessor of Medicine, Harvard Medical School

Dr. Mehra

Mandeep R. Mehra, MD, MSc, FRCP
The William Harvey Distinguished Chair in
Advanced Cardiovascular Medicine
Medical Director, Heart and Vascular Center
Brigham and Women’s Hospital
Executive Director
Center for Advanced Heart Disease
Brigham and Women’s Hospital
Professor of Medicine, Harvard Medical School 

 

MedicalResearch.com: What is the background for this study?

Response: Left Ventricular assist devices meaningfully prolong survival in patients with heart failure who are no longer responsive to guideline-directed medications.

The MOMENTUM 3 trial tested a new generation device, the HeartMate 3 pump, to a more commonly used pump, the HeartMate II device. This trial showed the superiority of the new heart pump and found that survival free of a disabling stroke or need to place a second pump is improved considerably.

In this prespecified analysis of the trial, we compared patients who were considered as eligible for transplantation to those considered ineligible for heart transplantation. We showed that these categories are associated with similar superiority of the HeartMate 3 pump compared to the control pump despite the categorization into these discrete buckets.

MedicalResearch.com: What should readers take away from your report?

Response: We believe that these findings should spur more patients to be considered for LVAD therapy, even if they are ineligible for transplantation. Further, some patients who fall in the gray zone between transplant eligible or ineligible should not be needlessly disadvantaged with delays in decision due to the need to provide discrete categories.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We need to see a larger number of patients referred for such therapy that are transplant-ineligible and to perform effective risk prediction models in such patients to achieve the best outcomes. Newer devices over time will make the technology not only forgiving but also forgettable by fully being internalized with a self-powered source.  

Any disclosures?

I am a consultant for Abbott and Medtronic and also provide scientific advice for companies including Nupulse, Leviticus and Fineheart. Each of these companies are developing heart pumps.

 

Citation:

Goldstein DJ, Naka Y, Horstmanshof D, et al. Association of Clinical Outcomes With Left Ventricular Assist Device Use by Bridge to Transplant or Destination Therapy IntentThe Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) Randomized Clinical TrialJAMA Cardiol. Published online January 15, 2020. doi:10.1001/jamacardio.2019.5323

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Last Modified: Jan 15, 2020 @ 10:13 pm

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