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Updated: Jul 18, 2026
06:10
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Evaluation of the ventricular assist device programme in the UK
L Sharples1, M Buxton, N Caine
1MRC Biostatistics Unit, Cambridge, UK.
Health Technology Assessment (Winchester, England)
|December 1, 2006
Summary
Ventricular assist devices (VADs) show a 52% 12-month survival rate in patients with advanced heart failure, but their cost-effectiveness is uncertain. Further UK-based trials are needed to evaluate newer VAD technology.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Transplantation Surgery
Background:
- Ventricular assist devices (VADs) are used to support patients with end-stage heart failure awaiting transplantation.
- Evaluating the clinical effectiveness and cost-effectiveness of VADs is crucial for healthcare resource allocation in the UK.
Purpose of the Study:
- To assess the clinical effectiveness and cost-effectiveness of VADs in UK heart transplant candidates.
- To collect data on survival, transplantation rates, health-related quality of life (HRQoL), and resource use.
- To develop cost-effectiveness and cost-utility models for VADs within the UK healthcare context.
Main Methods:
- A systematic review of clinical effectiveness and cost-effectiveness literature was conducted.
- Data on survival, HRQoL, and resource use were collected from VAD and non-VAD supported transplant candidates in the UK (April 2002-March 2005).
- Cost-effectiveness and cost-utility models were developed using UK data and patient outcomes.
Main Results:
- VAD patients achieved a 52% 12-month survival rate post-implantation, with 44% undergoing successful transplantation.
- Adverse events such as bleeding and infection were common, particularly in the first month post-implantation.
- Cost-effectiveness analysis indicated a mean lifetime incremental cost-effectiveness ratio (ICER) of £49,384 per QALY compared to a worst-case scenario, but VADs were not cost-effective against established thresholds when compared to non-VAD groups.
Conclusions:
- While VADs offer significant clinical benefits, achieving a 52% 12-month survival rate, their cost-effectiveness remains uncertain.
- Insufficient data exist for a definitive comparison, and VADs may not be cost-effective at traditional thresholds.
- Further randomized controlled trials using current VAD technology in the UK are recommended.
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