With the aging of the population, heart failure has emerged as a key public health concern. Several device-based technologies are poised to positively impact both ends of the disease spectrum, enabling earlier diagnosis and treatment, and providing more treatment options for those in later stages of the disease.

More than two years after being spun-out as Baxter's cardiovascular group, Edwards Lifesciences is establishing its identity as an independent company. A large part of this initial process has focused on which product lines to retain, which to divest, and what new areas to get into. Edwards emerged in the unusual position of having market leadership positions in several product areas, most significantly heart valves. But slow growth in those markets is limiting the extent to which they can drive overall company growth. Edwards' new strategy is to focus on advanced--stage cardiovascular disease with its primary customers being cardiac surgeons. Resource-constrained following the spin-out, the company is relying on a strategy unusual for device companies--alliance, rather than acquisitions--to expand its product offerings. But as the treatment of cardiovascular disease continues to rely increasingly on interventional techniques, the challenge for Edwards is to build a sustainable, broad-based business around selling to cardiac surgeons.

A new generation of miniature, totally implantable devices for end-stage congestive heart failure promises to return patients to normal lives. If the implantable ventricular assist devices can function reliably for many years, they may offer patients an alternative to heart transplantation and even arrest the progression of the diseases at earlier stages.

{Hemopump} inventor Richard Wampler, MD is behind Kriton Medical's new implantable miniature left ventricular assist device.