The Micromed Debakey VAD®: A Bridge to the Future

Ventricular Assist Device (VAD) therapy has emerged as a promising new option for the treatment of end-stage heart failure. As a bridge to heart transplantation, pulsatile VAD implantation has been performed over 3,000 times worldwide with a success rate of 50-70%.1,2 In the recent landmark REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) trial, end-stage heart failure patients, who received VAD but were ineligible for transplantation, were found to have a dramatic survival advantage over patients treated with optimal medical management (OMM).3 On the basis of these results, VAD implantation is now indicated for destination therapy that may impact the care of thousands of patients. Despite the survival advantages associated with mechanical support, these patients are at risk for device-specific complications. The first generation pulsatile Left Ventricular Assist Devices (LVADs) were large, noisy, prone to failure and infection, and expensive (approximately $70,000 per device).1 Recognizing these limitations, researchers began searching for alternative pump designs and axial flow impeller pumps emerged as the second generation of mechanical VAD. This article describes the development by Dr. George Noon, Dr. Michael E. DeBakey, and NASA engineers of the first axial flow pump for tong-term cardiac support.