New Hope for Failing Hearts

Eac

h year more than 500,000 Americans are diagnosed with congestive heart failure--a condition in which a weakened heart can't pump as much blood as the body needs. Drugs like beta-blockers help stabilize many patients in the earliest stages of the disease. But there aren't a lot of options for folks in the later stages. Heart transplants are one solution, but they're in short supply. The new AbioCor artificial heart shows promise, but it's still experimental; last week doctors reported that Robert Tools, the first recipient, had suffered a stroke.

That's why it's such good news to hear that another type of mechanical pump, called a left ventricular assist device, may be a viable alternative. Instead of replacing the heart entirely, the lvad attaches to the organ's left main chamber, boosting its output. The pump is twice as likely as drugs to keep patients alive after one year, according to a study that was published in the New England Journal of Medicine and presented last week at the American Heart Association meeting.

What's particularly impressive about the lvad study is that it was conducted as a randomized trial--one of the most rigorous scientific tests of any medical advance and one that's not often applied to surgical procedures. Although some patients still suffered from strokes and the LVADS sometimes failed, the quality of life for the majority of the patients in the study was significantly improved.

At present, LVADS are used primarily to buy time for patients who are waiting for a heart transplant. But the pumps had developed such a good track record over the years that doctors started to wonder if the devices could provide a more long-term solution.

Human hearts still provide both better quality of life and better chances for survival. But many folks with severe congestive heart failure don't qualify for heart transplants--often because they are too old. If the U.S. Food and Drug Administration approves the more-or-less permanent use of LVADS in people, says Dr. Eric Rose, the study's lead investigator and chief of surgery at Columbia-Presbyterian Medical Center in New York City, as many as 100,000 Americans could benefit.

Eventually LVADS might also be used in conjunction with some sort of regenerative heart therapy, using stem cells, for example. The mechanical pumps could then easily be removed, giving folks with severe congestive heart failure something they've never had before--some options.

For more info, see thoratec.com or e-mail gorman@time.com