Left ventricular assist devices for destination therapy in end-stage heart failure: the REMATCH trial

Patients in end-stage heart failure who were not eligible for heart transplantation were randomized in the REMATCH study (Randomized Evaluation of Mechanical Assistance in the Treatment of Congestive Heart failure) to receive either the Heartmate VE left ventricular assist device (LVAD) or optimal medical management (OMM) over a two year period. Only 25% of patients who received OMM were alive after one year, confirming the advanced nature of their heart failure. With LVAD therapy, there was a doubling of survival at one year and improved quality of life. The Heartmate left ventricular assist system provides an acceptable alternative therapy with a meaningful survival benefit in selected patients who are not candidates for heart transplantation.