SCCOR Grant Supports Extensive LVAD Research

$17 million will fund multiple studies addressing the biology of long-term mechanical support and the major limitations of Left Ventricular Assist Devices (LVADs).

Having proven the benefits of Left Ventricular Assist Devices (LVADs) in prolonging the lives of non-transplantable end-stage heart failure patients, the landmark REMATCH trial, directed by Principal Investigator Eric A. Rose, MD and the International Center for Health Outcomes and Innovation Research (InCHOIR), resulted in the historic FDA approval and Centers for Medicare and Medicaid Services (CMS) reimbursement for the devices. Since CMS approval in 2003, about 150 LVADs have been implanted as destination therapy and about 500 as bridge-to-transplantation (BTT). With better reimbursement rates now in place, that number is expected to rise. Yet while implantation of mechanical circulatory support devices is becoming standard practice as BTT, long-term "destination" therapy remains problematic due to serious adverse effects. Its life-saving potential notwithstanding, implantation of LVADs remains an invasive, demanding mechanical therapy, with significant risks of infection, bleeding, neurological complications, and device failure.

Awarded to the Columbia University College of Physicians and Surgeons in March 2005, the $17 million NIH grant is funding multiple basic and clinical studies to address these problems, with the goal of transforming LVADs into a safer and more widely accepted therapy. Investigators expect these improvements to benefit heart failure patients and make the therapy more cost-effective. This landmark project will include patients with advanced heart failure who receive LVADs as bridge-to-transplantation, destination therapy, and bridge-to-recovery.

The Specialized Centers of Clinically Oriented Research (SCCOR) is a program funded by the NHLBI to foster translational research in order to improve prevention, diagnosis, and treatment of particular diseases. When the Columbia investigators submitted their application in 2003, they received the highest score from among all applicants, and this grant represents the largest ever awarded in the field of mechanical circulatory support. "Because NYP/Columbia has such a strong program for heart failure and transplantation, it is natural that it would be a primary center for implantation of ventricular assist devices, and a central research institution in the field of mechanical circulatory support," says Mario C. Deng, MD.