pVAD safer, more cost-effective than surgical alternatives

Compared with traditional surgical hemodynamic support measures, percutaneous cardiac assist devices (pVAD) are less invasive and result in better outcomes, shorter lengths of stay, better survival rates and lower cost in patients with cardiogenic shock (CS), according to a study published online Jan. 13 in Catheterization and Cardiovascular Interventions.

Brijeshwar Maini, MD, of PinnacleHealth in Harrisburg, Penn., and colleagues used national and statewide data from 23 states on more than 1,000 patients with acute MI and CS who received pVAD therapy (including an Impella device manufactured by Abiomed) or traditional surgical hemodynamic support using extracorporeal membrane oxygenation or a left ventricular assist device with an intra-aortic balloon pump if deemed necessary by the physician.

They also collected financial and clinical data related to 30 patients who presented similarly and received an Impella 2.5 device between 2009 and 2011 at PinnacleHealth and made comparisons to national data.

Survival was better among pVAD patients (56 percent vs. 42 percent), and these patients also had a shorter length of stay (13.2 days vs. 17.9 days for traditional surgical alternatives). Admission costs were also significantly lower for pVAD patients ($90,929 vs. $144,257).

The PinnacleHealth patients who had pVAD therapy had a higher survival rate, a shorter length of stay of six days and admission costs of $53,850 compared with the surgical alternatives.

The authors argued that their data suggest the pVAD strategy may be most in line with the cost-saving and outcomes-improving goals of the modern U.S. healthcare system.

“With no incremental cost and a beneficial survival trend, pVADs are a dominant, cost-effective technology for this challenging patient population,” they wrote.