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To the Editor: The study of long-term outcomes and costs of ventricular assist devices by Dr Hernandez and colleagues¹ provided some interesting data, but because of the large amount of progress in this field over the past 2 years, it is of mostly historical value for comparisons with current outcomes with these devices. Also, the observations are too broad because of the inclusion of patients with multiple device indications, various devices used for diverse indications, and unknown indications for readmissions.

Mechanical circulatory support is moving rapidly away from pulsatile design pumps (the exclusive type reported by Hernandez et al) to a new generation of nonpulsatile, continuous flow design.² In one study, using the new design as a bridge to a transplantation resulted in 68% 1-year actuarial survival; at 3 months there was a 73% increase in patient-assessed quality of life by Kansas City Cardiomyopathy Questionnaire at 3 months (from 33 . . . [Full Text of this Article]

Leslie W. Miller, MD
leslie.w.miller@medstar.net
Department of Medicine
Washington Hospital Center
Washington, DC

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Long-term Outcomes and Costs of Ventricular Assist Devices Among Medicare Beneficiaries
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Outcomes of Medicare Beneficiaries With Ventricular Assist Devices—Reply
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