Evaluation of ventricular assist as a bridge to heart transplant or as destination therapy

L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)
Record ID 32003000003
Authors' objectives:

The aim of this report is to specify the indications for which ventricular assist has currently been validated, to specify the factors that determine its cost, and to propose ideas on how it could be organised nationally.

Authors' recommendations: The efficacy and safety of VADs as a bridge to transplant have been confirmed by case series studies carried out over long periods. It is difficult to interpret the results formally or to compare results between studies. They are presented globally even though there are considerable differences in the type of VAD used, in indications, in the way in which complications are defined and assessed, and in the experience of the various centres. Survival levels after VAD implantation have to be compared with the near-zero level of survival of patients with advanced heart failure (AHF). This comparison validates ventricular assist in the indication of bridge to transplant. Ventricular assist is still a major procedure with a high risk of complications (haemorrhage and/or thromboembolism or infection) resulting in a current level of morbidity that is still significant. Despite this persistant risk of complications, the quality of life of patients fitted with a VAD over a long period is satisfactory, being rated between the quality of life of patients without a VAD and that of patients who have had a heart transplant. There is little data concerning the use of VAD as destination therapy.
Authors' methods: Review
Project Status: Completed
URL for project: http://www.has-sante.fr/
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: France
MeSH Terms
  • Heart Diseases
  • Heart-Assist Devices
Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé
Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;
Contact Name: sh.leerobin@has-sante.fr
Contact Email: sh.leerobin@has-sante.fr
Copyright: L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)
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