title: [Improvements in implantable mechanical circulatory support systems : literature overview and update].
abstract: In recent years, ventricular assist devices (VAD) supporting the left (LVAD), the right (RVAD) or both ventricles (BVAD) have rapidly emerged as the standard of care for advanced heart failure patients. Both the numbers and ages of patients in which they are used are rising worldwide, especially when used as a permanent support (bridge to destination, BTD). Due to the continuing lack of donor organs, these devices now represent a viable alternative  to bridge patients to transplantation (BTT), with a 1-year survival rate of 86%. BTD, especially in long-term support, might be a valid, and the sole, option for those patients in whom heart transplantation is contraindicated. Patient selection, pre- and intra-operative preparation, as well as the timing of VAD implantation are important factors critical to successful circulatory support. While BTT remains the goal in the majority of patients, the number of permanent VADs (i. e. BTD) is rising significantly. Although explantation of a VAD system as a bridge to recovery (BTR) can be considered in only a small number of patients, it represents a very special part of this therapy modality.
authors.affiliation: Deutsches Herzzentrum Berlin, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Krabatsch
authors.forename: M
authors.initials: M
authors.lastname: Schweiger
authors.forename: A
authors.initials: A
authors.lastname: Stepanenko
authors.forename: T
authors.initials: T
authors.lastname: Drews
authors.forename: E
authors.initials: E
authors.lastname: Potapov
authors.forename: M
authors.initials: M
authors.lastname: Pasic
authors.forename: Y
authors.initials: Y
authors.lastname: Weng
authors.forename: M
authors.initials: M
authors.lastname: Huebler
authors.forename: R
authors.initials: R
authors.lastname: Hetzer
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D004867:Equipment Design; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006354:Heart, Artificial; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D018579:Patient Selection; D011474:Prosthesis Design; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018497:Ventricular Dysfunction, Right / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*