"We have 41 hospitals and less than half thereof are performing...

"We have 41 hospitals and less than half thereof are performing an implant a month. Is the market that immature/infantile or are there other competitive forces at work?"

As VCR stated not so long ago, there are several devices in trial atm - which in Aus/NZ and parts of Europe are not subject to reimbursement. So these will be used in preference to a commercialised device. In the US I suspect Thoratec et al have entrenched customer support especially while 3 gen competitors such as VCR still have trial device status.
Its a two-edged sword really - this reimbursement caper...
Makes VCR a commercial target as they are now competing for dollars despite not being FDA approved.