Six years of continuous mechanical circulatory support.

To the Editor: In 2001, a randomized trial comparing a pulsatile left ventricular assist device (LVAD) with medical therapy for end-stage heart failure reported a median survival advantage of 8.5 months for patients receiving the device.1 The patients' quality of life was limited by serious complications related to the LVAD. In 2000, we began a long-term observational study of circulatory support with a new, miniaturized axial-flow pump. At the time, there were important questions about the reliability of a blood pump powered by a rotary electric motor and the effects of diminished pulse pressure over time. Our first patient was . . .