C 25 o

Figure A.6. Age-adjusted death rates for congestive heart failure by race and sex, U.S. 1997. Death rates for CHF are relatively similar in blacks and in whites, but are slightly higher in males than in females.

The first clinical systems were designed to support, for days or weeks, the blood circulation of patients with dysfunctional hearts following cardiac surgery. This short-term support would enable the hearts of some patients to recover and establish normal function. More than 4,000 patients treated by a product of this program resulted in 33% being discharged to their homes (Fig. A. 7). Prior to this experience, only 5-10% of these patients were discharged.

BVS 5000 4,250 patients 33% Discharged

Figure A.7. Postcardiotomy heart dysfunction.

Clinicians learned that assist devices could "bridge" patients to cardiac transplant. For advanced heart failure and circulatory collapse, implantable ventricular assist devices restore the patient's circulation, allowing patients to leave the intensive care unit and regain strength before undergoing cardiac transplantation. Many patients received support for over one year, some for two or three years, with one patient supported for over four years. Table A.2 lists a tabulation of some 6,000 patients and the assist device used to discharge them to their homes (50-70% with cardiac transplants). The question remains, will these systems meet the overall program objective of providing destination therapy for heart failure patients?

Table A.2. Bridge-to-Cardiac Transplant

Device

Number of Patients

Heartmate

0 0

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