Bridge to Transplant
All patients waiting for heart transplant have weak hearts. Some patients become unstable even with good medical management. These patients may be considered for VAD placement as a bridge to transplant.

The heart transplant team will evaluate the patient for VAD placement, and see what type of device would be most appropriate for the patient's condition. The HeartMate® XVE can be used for left ventricular support only. The Thoratec device can be used to support either ventricle alone, or both ventricles.

Both devices are approved by the Food and Drug Administration for bridge to transplant therapy and can be used at home. They are available commercially and covered by most third party payers.

Destination Therapy
Patients with end-stage heart failure, who are not considered to be candidates for cardiac transplantation, may receive a VAD as destination therapy. This means that a VAD will be used as the permanent treatment for their heart failure. In general, patients need to be diagnosed with severe heart failure that causes significant symptoms despite medical treatment.

Specific tests, such as an echocardiogram or a special type of stress test may be needed to see if patients meet the qualifications. The patient's body size must also be large enough to have the VAD implanted. The HeartMate® XVE has been approved by the Food and Drug Administration for Destination Therapy. It is available commercially and covered by most third party payers.

The University of Iowa was involved with the research trial to help us understand if VAD therapy was better than conventional medical therapy for patients with end stage heart failure. It was called the REMATCH trial. Visit the Thoratec Destination Therapy FAQ's for more information about the REMATCH Trial.

For more information on VAD therapy at the University of Iowa, please contact the Cardiomyopathy Treatment Program at 319-356-1028.