Cardiac support devices still cause serious adverse events

A new study reports on 133 people with end stage heart failure who received mechanical cardiac support by a continuous flow pump (HeartMate II, Thoratec) while waiting for a heart transplant. The device is marketed as being small enough for women and adolescents; as having good mechanical reliability because only one part moves; and as being quieter than similar devices, making it more comfortable for patients.

Three quarters of the participants survived to 180 days and were either still eligible for transplantation and had a functioning mechanical circulation support, or they had received a heart transplant. At three months, people who received the device had better functional status and quality of life compared with baseline. None the less, adverse events were common, including postoperative bleeding, stroke, right heart failure, and percutaneous lead infection.

This observational study did not compare the procedure with any alternative approaches. The linked editorial (p 846) describes many similar devices, emphasises that no clinical trials have compared any of them head to head, and provides a guide on how to choose the most appropriate device for a given patient.