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Capstone

Efficacy of the HeartWare Ventricular Assist System in Bridging Adult Heart Failure Patients to Transplantation: A Systematic Review.

1 May 2011

Abstract

Background: Heart failure has a high mortality rate with 20% dying within the first year after diagnosis. The gold standard of treatment has been cardiac transplant however the shortage of donors continues to be a problem. Left ventricular assist devices (LVAD) have been bridging patients to transplantation, but they come with many complications. The HeartWare HVAD system is a promising new smaller LVAD that will hopefully improve the survival of heart failure patients awaiting transplant. The evidence of the clinical trials in this review was evaluated using the GRADE system.

Method: An exhaustive search of available medical literature was conducted using Medline, CINHAL, and Evidence-Based Medicine Reviews Multifile. The terms used in the search included the words, “Heartware, HVAD, and transplant” with limits set for human subjects, the English language, and articles published since the year 2000. After one clinical trial was found the author of that trial was searched to find the second article then included in this review.

Results: Two studies were reviewed in this systematic review. Both found that the HeartWare device was effective and safe in bridging end-stage heart failure patients to transplantation. The first study showed survival was 91% at 180 days and 86% at one year and the second study showed survival was 90% at 180 days, 84% at one year, and 79% at two years.

Conclusion: The HeartWare HVAD system is effective and safe in bridging end-stage heart failure patients to transplantation.

Keywords: HeartWare, HVAD, transplant, heart failure


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