1. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 178 Deaths * censored at transplant Percent Survival Months after Device Implant Deaths / Month Event: Death after Implant * Months % Survival 183 % 374 % 667 % 1250 % (423) (224) (137) (32) Hazard ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

2. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 Predicted % Mortality at 6 months Age (years) at Device Implant Primary Device Implant: LVAD alone (left ventricular failure) LVAD + RVAD at the same operation (biventricular failure) ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

3. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004 (n=655) Cumulative Events per 100 Patients Months after Device Implant Bleeding Episodes (n=396) Infection Episodes (n=668) Thromboembolism Episodes (n=86) 75 175 18 ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

4. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 66 Patients with Major Device Malfunction Percent Freedom from Major Device Malfunction Months after Device Implant Major Device Adverse Event / Month Event: Death after Implant * * censored at transplant Months % Survival 195 % 392 % 684 % 1266 % (410) (212) (122) (38) Hazard ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

5. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004 Bridge to Transplant Age > = 50 (n=292)Age < 30 (n=52) ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

6. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004 Intent to Treat: Bridge to Recovery (n=35) Months after Device Implant Proportion of Patients Alive (Still waiting) Death (before transplant) Explanted (recovery) Transplanted 17 % 12 % 27 % 45 % 5 % 12 % 37 % 45 % ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

7. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004 Intent to Treat: Destination Therapy (n=78) Months after Device Implant Proportion of Patients Alive Death Explanted (recovery) Transplanted 65 % 2 % 33 % 0 % 34 % 11 % 55 % 0 % ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

8. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004 Destination Therapy Age < 65 (n=37)Age >= 65 (n=41) ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

9. * Type of VAD not specified in 16 patients Primary Device Implantn LVAD (alone)542* Pulsatile flow, chronic device487 Continuous flow, chronic device 39 LVAD + RVAD Combinations100 TAH Pulsatile flow, chronic device 13 Total655 ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

10. Intention to Treatn % of 655 Bridge to transplant513 78.3% Bridge to recovery 35 5.3% Destination Therapy 78 11.9% Not specified 29 4.4% Total655 100% ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

11. Major Causes of Deathn% of 178 Multiple organ failure6234.8% Hemorrhage2715.2% Cardiovascular2212.4% Stroke1810.1% Infection147.9% Pulmonary95.1% Other2413.5% Unspecified21.1% Total178100% ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

12. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 Risk factors for death* after device implant Risk FactorRelative RiskP-value EARLY PHASE OF HAZARD Concurrent placement of RVAD4.89<.0001 Age (older)3.13<.0001 Female2.53.0003 Platelet count (lower)2.13.02 WBC count (higher)2.01.008 Blood type A1.89.008 CONSTANT PHASE OF HAZARD Diabetes2.01.01 Ventilator (pre-implant)1.84.03 Creatinine (higher)1.64.05 *Patients are censored at time of transplant. ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

13. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 Summary of Post-Implantation Patient-related Events Event# of Patients% of all Patients Infection13432.5% Bleeding11527.8% Arrhythmia10024.2% Renal dysfunction8520.6% Respiratory dysfunction6616.0% Neurological dysfunction5814.0% Right ventricular dysfunction4410.7% Hepatic dysfunction307.2% Cardiac tamponade225.3% Thrombotic vascular complication184.4% Hematoma102.4% Pleural effusion92.2% Internal organ compromise51.2% Pacemaker implanted20.5% ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

14. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 Major Device Malfunctionsn Controller 31 Pump/pump drive unit 14 Pump thrombosis 13 Pump inflow 11 Percutaneous lead/drive line 4 Pump outflow 4 Cannula dislodgement 1 Power base electrical malfunction 1 Pump stoppage 1 Other 3 Total Events 83 66 Patients with 83 major device malfunctions ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

15. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 Intent to Treat: Bridge to Recovery * Type of VAD not specified in 4 patients Primary Device Implantn LVAD (alone)21* Pulsatile flow, chronic device16 Continuous flow, chronic device 1 LVAD + RVAD Combinations14 Total35 ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

16. Indications for Destination Therapyn% of 78 Advanced age3848.7% Co-morbidity2835.9% Fixed pulmonary hypertension 810.3% Contraindication to immunotherapy 2 2.6% Patient refuses transplant 2 2.6% Total 78 100% ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

17. ISHLT/MCSD Analysis: Jan 2002 – Dec 2004, n=655 Intent to Treat: Destination Therapy Primary Device Implantn LVAD (alone)74 Pulsatile flow, chronic device71 Continuous flow, chronic device 3 LVAD + RVAD Combinations 3 TAH Pulsatile flow, chronic device 1 Total 78 ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187

18. Centers Contributing to the ISHLT MCSD Database ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187 COUNTRYCENTER AUSTRIAUniversitätsklinik für Chirurgie, Wien BELGIUMCliniques Universitaires St. Luc Universitair Ziekenhuis Antwerpen, Edegem University Hospital Gasthuisberg/Catholic Univ. of Leuven CANADAOttawa Heart Institute Quebec Heart Institute – Laval Hospital The Toronto General Hospital St Pauls Hospital FRANCEC.H.U. Henri Mondor – Univ Paris XII Hopital La Pitie – Salpetriere GERMANYUniversitätsklinikum Erlangen Herz-& Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen Chirurgische.Universitaetsklinik/University of Freiburg ISRAELSheba Medical Center ITALYIstituto Clinico Humanitas Niguarda CA Granda Hospital SINGAPORENational Heart Centre

19. Centers Contributing to the ISHLT MCSD Database ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187 COUNTRYCENTER UNITED STATESUniversity of Alabama Hospital University Medical Center, University of Arizona California Pacific Medical Center Washington Hospital Center St. Lukes Hospital (Jacksonville) University of Iowa Hospitals and Clinics Rush-Presbyterian/St. Lukes Med. Center OSF St Francis Medical Center Advocate Christ Medical Center Lutheran Heart Center St Vincent Hospital and Health Care Center Jewish Hospital Oschner Medical Institutes New England Medical Center Massachusetts General Hospital Johns Hopkins Hospital University of Michigan Medical Center Fairview University Medical Center St Marys Hospital, Mayo Clinic Barnes Jewish Hospital Carolinas Medical Center Duke University Medical Center Bryan LGH Medical Center East Newark Beth Israel Medical Center

20. Centers Contributing to the ISHLT MCSD Database ISHLT 2005 J Heart Lung Transplant 2005;24:1182-1187 COUNTRYCENTER UNITED STATES (continued)Montefiore Medical Center Columbia Presbyterian Medical Center Westchester Medical Center Ohio State University Hospital University of Cincinnati Medical Center University Hospital Cleveland Clinic Foundation St Francis Hospital Oregon Health Sciences & University Hospital Providence Portland Medical Center Hershey Medical Center Temple University Hospital University of Pittsburgh Medical Center Baptist Memorial Hospital Vanderbilt Transplant Center Seton Medical Center Medical City Dallas Hospital Baylor University Medical Center The Methodist Hospital (Houston) LDS Hospital University of Utah Medical Center Inova Fairfax Hospital MCV Hospitals Sacred Heart Medical Center University of Wisconsin Hospital St. Lukes Medical Center (Milwaukee)