Left ventricular assist devices: review of historical context, clinical indications, and device-related adverse events.

Abstract

Left ventricular assist devices (LVADs) have revolutionized medical treatment for patients with end-stage heart failure (HF), a major contributor of morbidity and mortality in the United States and worldwide, with > 30 million people affected. Despite advances in pharmacological therapy, many people with HF have progressive disease necessitating escalation of medical and surgical care. Orthotopic heart transplantation is the gold standard and provides de fi nitive treatment for end-stage HF; however, short supply of donor hearts limits this option in many patients. LVADs have emerged as an alternative option, with escalation in usage in the last 2 decades. Widespread use of LVADs has decreased mortality and improved quality of life for patients with end-stage HF. Since their advent in the 1960s, LVAD use has evolved from bridge-to-transplant into destination therapy. 1 This study discusses the emergence of LVADs, current indications for use, types of devices, hemodynamic management, and limitations associated with their use. the 2-year follow-up long-term outcome assessed the and ef fi cacy of a for of HVAD