New Milestone, New Hope

By the time Rebecca Butler Holder received her heart-lung transplant, she had overcome two major hurdles. Since only 2,000 donor hearts become available each year, she was blessed to receive the new organs, and she was fortunate to even qualify for the transplant waiting list. Millions of patients with heart failure are not eligible for a heart transplant because of age or a variety of health conditions. Now, they have a new option.

The Texas Heart Institute at St. Luke’s Episcopal Hospital is among one of the nation’s first cardiovascular centers to offer the Thoratec HeartMate SNAP-VE left ventricular assist system as a permanent implant, called “destination therapy,” for end-stage congestive heart failure patients who are ineligible for heart transplantation.

The Food and Drug Administration recently approved the HeartMate for destination therapy based on results of a landmark clinical trial. The Randomized Evaluation of Mechanical Assistance in Congestive Heart Failure, or REMATCH trial, demonstrated that the device nearly doubled and tripled survival at one and two years respectively, and improved quality of life in the patients studied. Physicians at the Texas Heart Institute and St. Luke’s have implanted 178 HeartMate devices since 1986.

“Currently, more than 4 million people are being treated for heart failure in the U.S., for whom a transplant will never be an option. This is a milestone – the first truly acceptable solution for long-term support of these patients because it allows them to leave the hospital and return to active, productive lives,” says Bud Frazier, M.D., chief of cardiopulmonary transplantation and director of surgical research at the Texas Heart Institute and chief of transplant service at St. Luke’s Episcopal Hospital. The cardiovascular surgeon and his research team have been involved in the development and testing of the HeartMate for more than 25 years.

The Texas Heart Institute at St. Luke’s originated the laboratory and clinical research of the device and implanted the first 20 HeartMates in the world. Frazier and his team initiated the research, which led to the REMATCH study and have implanted more of the devices than any other heart center worldwide. The FDA, which is restricting permanent implantation of the HeartMate to the sickest patients, estimates the implantation will be an option for 20,000 to 30,000 people each year who have end-stage congestive heart failure and don’t qualify for a transplant.

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©2006 Texas Medical Center

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