Update on ventricular assist devices.
OBJECTIVE
Over the past two decades, medicine has seen a robust increase in the use of ventricular assist devices. The purpose of this review is to update the information concerning these devices, their advantages and disadvantages as well as their complications. This is essential, as the demand for these devices is increasing due to the increasing number of patients with end-stage heart failure and limited number of donor hearts available for transplantation.


RESULTS
First-generation devices consisted of large, cumbersome consoles requiring patient immobilization and often times hospitalization in an ICU setting. Second-generation models focused on patient mobility and discharge from hospital with an improvement in infection rates as well as 1 and 2-year survival rates. Designs for newer devices are focusing on full implantation without percutaneous lines, axial flow mechanisms and patient comfort. Additionally, total artificial hearts are being designed for the treatment of biventricular failure. The indications for ventricular assist devices are also being expanded to include destination therapy and alternatives to cardiac transplantation, as the supply of organs continues to be limiting.


CONCLUSIONS
This paper reviews the characteristics, outcomes and design of ventricular assist devices.
Mitter
Nanhi
N
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA. nmitter1@jhmi.edu
Sheinberg
Rosanne
R
D006333:Heart Failure / Q000628:therapy*; D006354:Heart, Artificial / Q000639:trends; D006353:Heart-Assist Devices / Q000639:trends*; D006801:Humans