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Heart Disease (Expert Forum)
LVAD
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LVAD
by beckylilly, Apr 10, 2002 12:00AM
If a patient has an AMI and goes in to cardiac shock (no prior history of heart problems) and an LVAD is placed is this considered experimental?
Information regarding LVAD placement states the patient must be a candidate for heart transplantation yet to be a candidate for transplant you need to be evaluated, can not have had an MI within the last six weeks and have to be in relatively good health.
Would someone in Cardiac Shock be considered a heart transplant candidate?
The language is very confusing. FDA has approved LVAD placement for those that have received an evaluation and are awaiting a transplant yet those with dire problems such as an acute MI and cardiac shock are the ones that need the LVAD - is it then considered a bridge?
Information regarding LVAD placement states the patient must be a candidate for heart transplantation yet to be a candidate for transplant you need to be evaluated, can not have had an MI within the last six weeks and have to be in relatively good health.
Would someone in Cardiac Shock be considered a heart transplant candidate?
The language is very confusing. FDA has approved LVAD placement for those that have received an evaluation and are awaiting a transplant yet those with dire problems such as an acute MI and cardiac shock are the ones that need the LVAD - is it then considered a bridge?
Doctor's Answer
by CCF-M.D.-CRC, Apr 10, 2002 12:00AM
Dear beckylilly,
Left ventricular assist devices (LVADs) are small implantable pumps that are used in situations where the heart is unable to meet the body's need for oxygen delivery. Up to this point they have been primarly used as a "bridge to heart transplant". In other words a person who has met criteria and is waiting for a transplant but would die before the donor organ became available would have a LVAD placed while waiting. Recently a trial called REMATCH was released in which persons who were not transplant candidates were given LVADs as a long-term therapy. The initial results of this trial were promising and hopefully there will be increased implant criteria soon.
In regard to your question I suspect the underlying motive behind this question is an insurance dispute. Insurance companies are reluctant to pay for anything they consider "experimental". This is especially true in the case of an LVAD which is very expensive ($100,000+ dollars) Without knowing the details of the case I couldn't really comment on the appropriateness of placing the LVAD. Your best thing to do in this situation is to have the doctor be an advocate for your case. Many insurance companies will reconsider their decision after discussing the case with the attending physician.
Left ventricular assist devices (LVADs) are small implantable pumps that are used in situations where the heart is unable to meet the body's need for oxygen delivery. Up to this point they have been primarly used as a "bridge to heart transplant". In other words a person who has met criteria and is waiting for a transplant but would die before the donor organ became available would have a LVAD placed while waiting. Recently a trial called REMATCH was released in which persons who were not transplant candidates were given LVADs as a long-term therapy. The initial results of this trial were promising and hopefully there will be increased implant criteria soon.
In regard to your question I suspect the underlying motive behind this question is an insurance dispute. Insurance companies are reluctant to pay for anything they consider "experimental". This is especially true in the case of an LVAD which is very expensive ($100,000+ dollars) Without knowing the details of the case I couldn't really comment on the appropriateness of placing the LVAD. Your best thing to do in this situation is to have the doctor be an advocate for your case. Many insurance companies will reconsider their decision after discussing the case with the attending physician.
Member Comments (2)
by beckylilly, Apr 10, 2002 12:00AM
Thank you for your prompt response - I think I will follow your direction. Have a wonderful day.
