title: Ventricular assist device implantation in the elderly.
abstract: BACKGROUND
  Dramatic advances in ventricular assist device (VAD) design and patient management have made mechanical circulatory support an attractive therapeutic option for the growing pool of elderly heart failure patients.
  
  
  METHODS
  A literature review of all relevant studies was performed. No time or language restrictions were imposed, and references of the selected studies were checked for additional relevant citations.
  
  
  RESULTS
  In concordance with the universal trend in mechanical circulatory support, continuous flow devices appear to have particular benefits in the elderly. In addition, the literature suggests that early intervention before the development of cardiogenic shock, important in all patients, is particularly paramount in older patients.
  
  
  CONCLUSIONS
  The ongoing refinement of patient selection, surgical technique, and post-operative care will continue to improve surgical outcomes, and absolute age may become a less pivotal criterion for mechanical circulatory support. However, clear guidelines for the use of mechanical circulatory support in the elderly remain undefined.
authors.affiliation: 1 Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA ; 2 Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA ; 3 Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: William
authors.initials: W
authors.lastname: Hiesinger
authors.affiliation: 1 Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA ; 2 Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA ; 3 Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Jack H
authors.initials: JH
authors.lastname: Boyd
authors.affiliation: 1 Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA ; 2 Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA ; 3 Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Y Joseph
authors.initials: YJ
authors.lastname: Woo
keywords: Ventricular assist device (VAD); elderly; heart failure; mechanical circulatory support