Heart failure

Congestive heart failure occurs when the heart loses its ability to pump enough blood to the lungs and tissues. Heart failure is a condition that can be caused by various diseases, such as myocardial infarction, hypertension, heart valve diseases or heart muscle diseases. The main symptoms of heart failure are shortness of breath, body swelling and fatigue. Heart failure is usually classified according to New York Heart Association (NYHA) Classification, and divided medically and functionally into four classes. In heart failure class 1 and 2 and to some extent even Class 3, symptoms can be treated with medication. For patients with advanced heart failure class 4 the only realistic alternative is heart transplant surgery. Patients with advanced heart failure with Class 4, does not tolerate slightest physical exertion. They suffer from shortness of breath and severe fatigue even when resting. If these patients are not transplanted they will all usually die within a year.

Heart failure is an incurable condition that with time often develops into class 4. The road to transplantation or death in heart failure involves great suffering and these patients need a lot of care and nursing. Patients with severe heart failure have generally continuously hospitalized. It is costly to transplant a heart. It requires extensive logistics with several surgical teams and air transport to carry out the transplant. Post-transplant, the patient is also dependent on immunosuppressive medication to reduce the risk of rejection of the transplanted heart.

The biggest problem is that the availability of donor hearts is very limited and only about 5,000 are transplanted each year worldwide. Annually, an estimated 50 000 patients are suffering from such an advanced heart failure that they are placed on the transplantation list. Most of these patients die while waiting for a donated heart.

The number of patients with advanced heart failure and in need of help are much greater than those placed in the donation list. Only the sickest patients are placed on the list.

In the United States alone it is estimated that about 250,000 patients with advanced heart failure die every year, and about half of these patients die suddenly of a heart attack without having the opportunity to treatment such as heart transplantation or a heart pump. Other patients can be saved by a heart transplant, but there is a shortage of donated hearts and only 2,000 transplants are performed each year in the United States. The heart pump manufacturer AbioCor has estimated the need in the US to be about 100 000 heart pumps per year.

European Society of Cardiology has 47 member countries with a total of approximately one billion people and has estimated that about 10-30 million (1-3%) suffer from heart failure at various stages. The 5-years mortality rate among these patients is about 75%, which means that at least 1 million die each year. Of these, it is estimated that at least 100,000 patients are candidates for a heart pump.

Global statistics on the number of patients with advanced heart failure are limited.