title: An update on mechanical circulatory support for heart failure therapy.
abstract: OBJECTIVE
  This article aims to review contemporary studies that utilized mechanical circulatory support (MCS) in the treatment of heart failure and to elaborate on prospective mechanical alternatives.
  
  
  RESULTS
  There is a growing need for a well-tolerated, durable and effective MCS option in patients with refractory heart failure. In previous years, the primary indication for MCS therapy supported bridge to transplantation. These early left ventricular assist devices (LVADs) suffered significant adverse events, thereby limiting their prolonged use. With the introduction of newer continuous flow LVADs, with lower morbidity, neurological events, pump failure and the expanded indication use (i.e. destination therapy), the overall number of implanted patients has grown.
  
  
  CONCLUSIONS
  There has been a dramatic advancement of durability found in the second and third-generation, continuous flow LVADs, along with improved survival rates in patients receiving these devices for destination therapy. MCS may soon become the treatment option of choice in refractory heart failure patients, especially with further evolution of less invasive approaches, smaller designs, and energy sources.
authors.affiliation: aDivision of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada bDivision of Cardiac Surgery, Harvard University, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Hadi Daood
authors.initials: HD
authors.lastname: Toeg
authors.forename: Talal
authors.initials: T
authors.lastname: Al-Atassi
authors.forename: Jose Perez
authors.initials: JP
authors.lastname: Garcia
authors.forename: Marc
authors.initials: M
authors.lastname: Ruel
mesh_terms: D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000639:trends