Doctors say that a new type of heart pump greatly improves survival of people with severe heart failure. It could become the first one of these devices to be widely used as a permanent treatment.
The device is implanted next to a patient's own heart to help it pump. In a study, the new device increased by four times the number of patients who survived at least two years, compared to an older pump that is used now just for short periods to keep people alive until a heart transplant can be done.
The big issue is cost. The pump costs $80,000, plus $45,000 for the surgery and hospital stay to implant it.
"It will allow older people who are not heart transplant patients to stay alive but at a higher cost. It's all about who's going to pay," said Cleveland Clinic heart chief Dr. Steven Nissen, who had no role in the research.
The device — called the HeartMate II and made by Thoratec Corp. of Pleasanton, Calif. — is the first of a new generation of smaller pumps that push blood continuously rather than simulating a heartbeat as older pumps do. A wire from the patient's abdomen connects the device to a small computer and batteries the patient wears in a belt pack.
The pump was approved last year for use in people waiting for a transplant. The new company-funded study tested it in very sick heart failure patients not eligible for a transplant.
It enrolled 200 people as young as 26 and as old as 81 at several sites in the United States. Two-thirds got the new device; the rest received an older HeartMate pump. After two years, 46 percent of those on the new pump and 11 percent of those on the old one were alive without having suffered a stroke or needing an operation to fix or replace the device.
Results were presented Tuesday at an American Heart Association conference and published by the New England Journal of Medicine.