{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:05:33Z","timestamp":1784279133935,"version":"3.55.0"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Cardiol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of the HeartMate 3 (HM3) left ventricular assist device (LVAD) as a destination therapy (DT) for patients with end-stage heart failure (HF) ineligible for transplantation, from a Peruvian healthcare perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A health technology assessment (HTA) was conducted, which included a systematic review of clinical effectiveness and safety, complemented by a critical appraisal of relevant evidence. Searches were performed in 3 databases, complemented by manual searches in HTA organizations and clinical practice guidelines (CPGs) repositories. The search included CPGs, HTAs, randomized clinical trials (RCTs), and high-quality observational studies evaluating LVADs for DT. Cost-effectiveness analyses and device costs specific to the Peruvian context were also reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All the CPGs supported the use of the HM3 LVAD, emphasizing its significant survival benefits demonstrated in primary studies. The HM3 showed a 5-year survival rate exceeding 50%, compared to 25% at 1\u2009year and 8% at 2\u2009years with optimal medical therapy (OMT). Functional and quality of life outcomes also improved significantly. However, common adverse events included bleeding and infections. Cost-effectiveness analyses from high-income settings indicated that the HM3 exceeded conventional willingness-to-pay thresholds but highlighted its critical clinical benefits for high-risk patients with no alternative therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The HM3 LVAD offers significant survival and quality of life improvements for patients with end-stage HF ineligible for transplantation. Despite challenges in cost-effectiveness, the adoption of the HM3 as DT in Peru is justified to address a critical unmet clinical need, provided robust medical device surveillance is implemented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795468261433692","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:04:38Z","timestamp":1784095478000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Implantable Left Ventricular Assist Devices for Destination Therapy: A Peruvian Health Technology Assessment"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4664-2856","authenticated-orcid":false,"given":"Carlos J.","family":"Toro-Huamanchumo","sequence":"first","affiliation":[{"name":"OBEMET Center for Obesity and Metabolic Health, Lima, Peru"},{"name":"Universidad San Ignacio de Loyola, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Rivera-Santill\u00e1n","sequence":"additional","affiliation":[{"name":"Instituto de Evaluaci\u00f3n de Tecnolog\u00edas en Salud e Investigaci\u00f3n - IETSI, EsSalud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolay Z.","family":"Vasquez-Quispe","sequence":"additional","affiliation":[{"name":"Instituto de Evaluaci\u00f3n de Tecnolog\u00edas en Salud e Investigaci\u00f3n - IETSI, EsSalud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julissa E.","family":"Venancio-Huerta","sequence":"additional","affiliation":[{"name":"OBEMET Center for Obesity and Metabolic Health, Lima, Peru"},{"name":"Instituto de Evaluaci\u00f3n de Tecnolog\u00edas en Salud e Investigaci\u00f3n - IETSI, EsSalud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy J.","family":"Gendrau-Castillo","sequence":"additional","affiliation":[{"name":"Instituto de Evaluaci\u00f3n de Tecnolog\u00edas en Salud e Investigaci\u00f3n - IETSI, EsSalud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Peralta","sequence":"additional","affiliation":[{"name":"Instituto de Evaluaci\u00f3n de Tecnolog\u00edas en Salud e Investigaci\u00f3n - IETSI, EsSalud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel M.","family":"Castro-Reyes","sequence":"additional","affiliation":[{"name":"Instituto de Evaluaci\u00f3n de Tecnolog\u00edas en Salud e Investigaci\u00f3n - IETSI, EsSalud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Zavala-Loayza","sequence":"additional","affiliation":[{"name":"Instituto de Evaluaci\u00f3n de Tecnolog\u00edas en Salud e Investigaci\u00f3n - IETSI, EsSalud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.098814"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhl.2002.124554"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.01.014"},{"issue":"18","key":"e_1_3_2_5_2","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"145","author":"Heidenreich PA","year":"2022","unstructured":"Heidenreich PA, Bozkurt B, Aguilar D. 2022 AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines. 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