Mark S. Slaughter on New Options for Patients with Severe Heart Failure
New Hot Paper Commentary, July 2011
|
Article: Advanced Heart Failure Treated with Continuous-Flow Left Ventricular Assist Device
Authors: Slaughter, MS;Rogers, JG;Milano,
CA;Russell, SD;Conte, JV;Feldman, D;Sun, B;Tatooles,
AJ;Delgado, RM;Long, JW;Wozniak, TC;Ghumman, W;Farrar,
DJ;Frazier, OH;HeartMate II Investigators |
Mark S. Slaughter talks with ScienceWatch.com and answers a few questions about this month's New Hot Paper in the field of Clinical Medicine.
Why do you think your paper is highly
cited?
Our paper "Advanced heart failure treated with continuous-flow left ventricular assist device" was very important and now frequently cited for several reasons. This publication clearly demonstrated the improvements and superiority of the new continuous flow technology compared to the earlier pulsatile flow technology that we had been using. Equally important, the improved survival rates now are not only statistically significant but clinically relevant compared to optimal medical therapy for treating advanced heart failure.
Both of these issues were acknowledged by Dr. Jim Fang in his accompanying editorial in which he states that patients with advanced heart failure should all be referred for evaluation and possible treatment with a LVAD.
Does it describe a new discovery, methodology, or
synthesis of knowledge?
View PDF file with More figures and
descriptions.
The paper was the next step in demonstrating the consistent and progressive improvement in device technology to treat advanced heart failure.
Would you summarize the significance of your paper
in layman's terms?
Our paper provides the evidence that there are new options for patients with severe heart failure that are not eligible for a heart transplant.
How did you become involved in this research, and
how would you describe the particular challenges, setbacks, and
successes that you've encountered along the way?
I have a background in engineering and thus have always been looking for ways to apply engineering principles to help solve medical problems. If we can send a man to the moon safely it seems as though we should be able to make a mechanical pump to help or replace a failing human heart.
Over time, many of the challenges that were encountered with early pump design have been improved or solved. This has been accomplished by teamwork and collaboration between physicians, surgeons, engineers, and basic scientists. It has been an incredible journey which has now resulted in the improved survival and quality of life for many patients that had no options.
Where do you see your research leading in the
future?
The future for this technology is very exciting. There will continue to be improvements in pump design, miniaturization, and overall performance. We are now starting to use these devices to recover failing hearts. The new LVADs will be used in conjunction with cell therapy to improve and/or grow new heart muscle. This will ultimately allow for the device to be removed when the heart is strong again. Also, with improvements in pump design and performance, it is possible that it will replace or be an equal substitute for a heart transplant. This way patients will not have to wait months or years to receive treatment for severe heart failure that is not responding to medical therapy.
Do you foresee any social or political
implications for your research?
At this time, treatment with a LVAD for advanced heart failure is an
expensive therapy. Like all new devices, the cost will be reduced when
there is more competition from device manufacturers and an increase in the
number of devices sold. However, with the ongoing efforts to contain health
care costs, we will need to continue to look for new ways to make the
devices more cost competitive and better identify which patients will
receive the most benefit from this advanced treatment
option.
Mark S. Slaughter, MD
Professor and Chief
Division of Thoracic and Cardiovascular Surgery
Director Mechanical Assist Device and Heart Transplant Program
Associate Medical Director Cardiovascular Innovation Institute
University of Louisville
Louisville, KY, USA
ADDITIONAL INFORMATION:
- (Commentary for Mar. 2011 [late entry])
KEYWORDS: ADVANCED HEART FAILURE, CONTINUOUS-FLOW LEFT VENTRICULAR ASSIST DEVICE, LVAD, HEARTMATE II, CARDIAC RESYCHRONIZATION THERAPY, MECHANICAL CIRCULATORY SUPPORT, DESTINATION THERAPY, EJECTION FRACTION, DEFIBRILLATOR, SURVIVAL, IMPLANTATION, OUTCOMES, MORBIDITY, MORTALITY.