Left ventricular assist devices in heart failure

Abstract

End-stage heart failure is an ever-growing and devastating disease. The median survival for patients with heart failure on ionotropic support alone is a meager 6 months. Historically, the only option for these patients was to be listed for heart transplantation. Out of medical necessity, the idea of left ventricular assist device (LVAD) as a bridge to transplantation was born. Since their approval by the US FDA, LVADs have quadrupled the survival in patients with heart failure. The increase in survival has also been accompanied by decreased perioperative morbidity, better biocompatibility and longer device life over first-generation LVADs. Undoubtedly, LVADs have changed the landscape of heart failure treatment and will continue to do so in the foreseeable future. In this review, we will highlight the landmark studies that have established LVADs as a therapeutic option for heart failure, as well as reviewing the current LVADs available and speculating on the advancements that will be made in the upcoming years.

Keywords::

• bridge to transplant
• destination therapy
• heart failure
• mechanical circulatory support
• ventricular assist device

Financial & competing interests disclosure

G Ailawadi is a consultant at Abbott Vascular and Edwards Lifesciences, speaker/trainer at Atricure and speaker at St. Jude. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

Adapted with permission from [29].