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Benefits and risks

Benefits and risks

When NICE looked at the evidence, it decided that it showed implantation of a left ventricular assist device (LVAD) to be safe enough and work well enough for some people with chronic heart failure for whom a heart transplant isn't possible. The 7 studies that NICE looked at involved a total of 2795 patients.

Generally, they showed the following benefits:

  • improved survival: 68% to 74% of patients alive after 1 year, 23% to 67% alive after 2 years, compared against 8% of patients on medical treatment after 1–2 years

  • ability to walk almost twice as far in 6 minutes

  • improved quality of life 1 year after the procedure

  • better emotional outcomes at 1 year compared against medical treatment.

The studies showed that the risks of an LVAD (at 2 years) included:

  • death due to failure of the device in up to 2% of patients

  • death due to loss of power to external parts of the device in 2% of patients

  • ischaemic stroke in 7% to 8% of patients and haemorrhagic stroke in 8% to 11% of patients

  • right heart failure managed by drugs in 20% to 27% of patients and managed by a right ventricular assist device in 4% to 5% of patients

  • respiratory failure in 38% to 41% of patients

  • renal failure in 16% to 24% of patients

  • abnormal heart beat in 56% to 59% of patients

  • LVAD‑related infection in 35% to 36% of patients

  • pump needing replacement in 9% to 34% of patients

  • a blood clot in the pump in up to 4% of patients

  • bleeding that needed blood transfusion in 76% of patients and that needed more surgery in 23% of patients.

If you want to know more about the studies, see the guidance. Ask your health professional to explain anything you don't understand.

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