The US Food and Drug Administration (FDA) has approved Medtronic’s HeartWare HVAD system as a destination therapy for patients with advanced heart failure who are not candidates for heart transplants.
Designed to help the heart pump, the left ventricular assist device (LVAD) increases the amount of blood that flows through the body.
A mechanical, centrifugal flow pump, the HVAD System supports heart function and blood flow, continuously drawing oxygen-rich blood from the left ventricle to deliver to the rest of the body.
“LVADs are an effective and well-established treatment for patients who have progressed to advanced heart failure,” says Joseph Rogers, interim chair of the Department of Medicine at Duke University, and a co-principal investigator for the ENDURANCE and ENDURANCE supplemental trials. “In addition to its use as a bridge to heart transplantation, the HVAD system offers a promising option for a growing number of patients who are ineligible for transplant.”
Supporting evidence for HVAD therapy
FDA approval is based on results from the ENDURANCE and ENDURANCE supplemental trials, which enrolled nearly 1,000 destination therapy patients.
The data support the safety and effectiveness of the system for patients with advanced, refractory left ventricular heart failure as a bridge to cardiac transplantation (BTT), or myocardial recovery, or as destination therapy (DT) in patients for whom subsequent transplantation is not planned.
“We have been impressed with the overall clinical profile of the HVAD system, as evidenced by the ENDURANCE and ENDURANCE supplemental trials, which affirmed its safety and effectiveness as a life-saving therapy for patients,” says Francis D Pagani, surgical director of the Adult Heart Transplant Program and director of the Center for Circulatory Support at the University of Michigan Health System, and a co-principal investigator for the ENDURANCE and ENDURANCE Supplemental trials. “The new indication is extremely important for patients with end-stage heart failure as the HVAD System offers significant survival and quality-of-life benefits.”
The HVAD System received FDA approval in 2012 as a bridge to transplant in patients eligible for heart transplants. It also received CE mark that same year for patients at risk of death from refractory, end-stage heart failure, and it previously had received CE Mark for the bridge to transplant indication in 2009.
HeartWare was acquired by Medtronic last year for US$1.1 billion.