A number of interesting studies came out of this year's American College of Cardiology (ACC) meeting, providing some good (and a few not so good) results for several device-based cardiovascular therapies, including drug-eluting stents and heart failure and cardiac assist devices.

Thoratec's 34% increase in the revenue for 2008 was largely due to the introduction of its left ventricular assist device HeartMate II, a small axial flow pump weighing only 12 oz. while previous devices weighed three pounds. It took more than seventeen years for the HeartMate II to wend its way through development to the marketplace success that it is today, and that's not unusual in the LVAD space. But now, next generation LVADs with advantages are already nipping at Thoratec's heels. Thoratec's solution: consolidation. On February 13, Thoratec announced that it would acquire publicly-traded Australian LVAD company HeartWare International for $282 million, half in stock and half in cash.

MicroMed has the smallest LVAD on the market (outside of the US), which makes it suitable for the sought-after destination therapy market. The MicroMed LVAD has been implanted in more then 450 patients, which makes it second only to Thoratec in terms of the number of implants. But it hasn't been easy. To get to this point, MicroMed chewed through large helpings of money-seed funding, four rounds of venture capital, and a bank financing, before going public in 2005 through a reverse merger with a shell company. By the end of 2007, MicroMed needed to raise money on top of a large accumulated deficit. Rescue came from private equity group E-Wilson, which took the company private.

The market for cardiac assist devices has, in the past, been focused on end-stage patients waiting for a heart transplant, a niche market. But now, growth is accelerating in all sectors, from acute cardiac support to the long-term support of end-stage heart failure patients. Start-Up revisits CardiacAssist, CircuLite, and MicroMed.