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> If you can measure that of which you speak and can express it by a number, you know something of your subject; but if you cannot measure it, your knowledge is meager and unsatisfactory.> > Lord KelvinThe success or failure of left ventricular assist device (LVAD) therapy can be measured in several ways. The landmark clinical trials, REMATCH1 and INTrEPID,2 defined success in terms of mortality and morbidity, compared with standard medical therapy. Indeed, these are the primary benchmarks used by the US Food and Drug Agency when evaluating a device for market approval. On a grander scale, success may be measured in terms of the popularity or use of the therapy. In this respect, LVAD therapy could be deemed as an abject failure. Thirty years ago, the Office of Technology Assessment projected the annual need to be on the order of 100,000 in the United States and 200,000 worldwide3; yet the current rate of LVAD implantation has yet to achieve 5% of this target.Article see p 714For many of these intervening years, it was believed that the barriers to widespread growth of this therapy were the technology itself: the unsatisfactory safety and efficacy of the devices. Now that current LVADs …

Insanity of Left Ventricular Assist Therapy