Destination Therapy

#7

Cardiothoracic Surgery

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There are up to 100,000 people who are terminally ill with end-stage heart failure and for whom a heart transplant is not possible. Ventricular assist devices (VADs) can help patients who are not eligible for a heart transplant due to age, other health problems, or other complications. This purpose is called "destination therapy."

NewYork-Presbyterian offers VADs for such long-term destination therapy, improving patient's function and enabling them to live longer, productive lives. The VAD consists of:

Reprinted with Permission from Thoratec Corporation

An electric pump: The pump is implanted in the upper part of the abdominal wall and is connected to the heart at two points. A tube carries blood from the left ventricle to the pump. The blood is pumped through a second tube to the aorta, and distributed throughout the body.
An electronic control system: A third tube extends to the outside of the body and contains wires that connect the pump to the electronic control system.
A power supply (rechargeable batteries): The control system is connected to small batteries. Patients wear the controller on a belt and the batteries on a vest-like shoulder holster.

Research conducted at NewYork-Presbyterian has demonstrated that patients with the implanted HeartMate VAD had much better survival rates and quality of life compared patients who were treated with medication and were medically monitored.

The following devices are used to bridge patients to transplant:

DEVICE	DESCRIPTION	MORE INFORMATION
Thoratec HeartMate II®	This VAD features a small size that makes it suitable for a wide range of patients, including those of smaller stature. It is currently the gold standard. Patients receiving a HeartMate II may be discharged home from the hospital.	Learn more
HeartMate® XVE (also known as HeartMate I)	The HeartMate XVE is the only VAD for patients needing intermediate to chronic circulatory support that does not require the use of anticlotting drugs. Patients receiving a HeartMate XVE may be discharged home from the hospital.	Learn more
HeartWare™	This miniature ventricular assist device has one moving part -- an "impeller" -- which works in sync with a magnetic and hydrodynamic system to propel blood from the heart to other parts of the body. It is an investigational therapy.	Learn more