The VAD Paradigm Series

Access the latest discussions and case studies from experts in the field of ventricular assist device (VAD) therapy.

Extending the Therapeutic Horizon for AHF Patients

Within the last decade, treatment with mechanical circulatory support (MCS) has become an accepted standard of care for patients with advanced heart failure who have failed medical management.1 In this roundtable discussion between leading physicians in the fields of cardiology and thoracic surgery, the participants share their expertise in using ventricular assist devices (VADs), particularly the HeartMate II® Left Ventricular Assist System, to save and support individuals with failing hearts.

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VAD Expert Panel

John O'Connell, MD

John O'Connell, MD
Principal

Heart Failure Consultants
Sunset, SC

Walter Dembitsky, MD

Walter Dembitsky, MD
Medical Director, Cardiac Surgery, Mechanical Circulatory Support Program

Sharp Memorial Hospital
San Diego, CA

Ranjit John, MD

Ranjit John, MD
Associate Professor, Department of Surgery, and Surgical Director, Mechanical Circulatory Support Program

University of Minnesota
Minneapolis, MN

Jaap Lahpor, MD

Jaap Lahpor, MD
Professor of Cardiothoracic Surgery, Heart Lung
Center Utrecht

University Medical
Center Utrecht
Utrecht, Netherlands

Jonathan Rich, MD

Jonathan Rich, MD
Assistant Professor, Cardiology, and Associate Director, Mechanical Circulatory Support Program

Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital
Chicago, IL

PART I

Anticipated Time Horizon for VAD Support

Survival with VADs has increased dramatically over time, with expectations shifting from days to years. In Part I, our expert panel discuss the anticipated time horizon for support in the context of recent data, the AHA/ACC Guidelines, and their own clinical experiences.


PART II

Incorporating VAD Implantation Earlier in Heart Failure Progression

The long-term results achieved with VAD support, in terms of both survival and quality of life, raise questions regarding the importance of earlier implantation. In Part II, our expert panel share their views about the timing of therapy, the treatment of refractory and elderly patients, and how multidisciplinary decision-making can benefit patients.


PART III

Support Structure for VAD Program Success

As more patients are supported for longer periods of time, different types of additional support structures, as well as measurements for their success, will be required. In Part III, the participants discuss their experience with Thoratec Shared Care™—a partnership program dedicated to comanaging HeartMate II recipients and enabling a smooth transition home for patients.


Disclosures:
Dr O'Connell discloses that at the time of the roundtable discussion, he was a paid consultant for Thoratec Corporation. As of September 30, 2013, he is a full-time employee of Thoratec Corporation. Dr O'Connell also discloses that he is on the Data and Safety Monitoring Committee for Auven Therapeutics.

Dr Dembitsky discloses that he is a paid consultant and lecturer for, and has received research grants from, Thoratec Corporation.

Dr John discloses that he is a paid consultant for, and has received research grants from, Thoratec Corporation.

Dr Lahpor discloses that he is a paid consultant and speaker for Thoratec Corporation.

Dr Rich discloses that he has received honoraria in the past from Thoratec Corporation.

Reference:

1. Peura JL, Colvin-Adams M, Francis GS, et al. Recommendations for the use of mechanical circulatory support: device strategies and patient selection: a scientific statement from the American Heart Association. Circulation. 2012;126(22):2648-2667.