title: Durable Mechanical Circulatory Support versus Organ Transplantation: Past, Present, and Future.
abstract: For more than 30 years, heart transplantation has been a successful therapy for patients with terminal heart failure. Mechanical circulatory support (MCS) was developed as a therapy for end-stage heart failure at a time when cardiac transplantation was not yet a useful treatment modality. With the more successful outcomes of cardiac transplantation in the 1980s, MCS was applied as a bridge to transplantation. Because of donor scarcity and limited long-term survival, heart transplantation has had a trivial impact on the epidemiology of heart failure. Surgical implementation of MCS, both for short- and long-term treatment, affords physicians an opportunity for dramatic expansion of a meaningful therapy for these otherwise mortally ill patients. This review explores the evolution of mechanical circulatory support and its potential for providing long-term therapy, which may address the limitations of cardiac transplantation.
authors.affiliation: Department of Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX 77030, USA.
authors.forename: Jatin
authors.initials: J
authors.lastname: Anand
authors.affiliation: Department of Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX 77030, USA.
authors.forename: Steve K
authors.initials: SK
authors.lastname: Singh
authors.affiliation: Department of Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX 77030, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Antoun
authors.affiliation: Department of Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX 77030, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Cohn
authors.affiliation: Department of Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX 77030, USA.
authors.forename: O H Bud
authors.initials: OH
authors.lastname: Frazier
authors.affiliation: Department of Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX 77030, USA.
authors.forename: Hari R
authors.initials: HR
authors.lastname: Mallidi
mesh_terms: D001243:Assisted Circulation / Q000295:instrumentation / Q000379:methods*; D006333:Heart Failure / Q000473:pathology / Q000628:therapy*; D016027:Heart Transplantation / Q000379:methods; D006353:Heart-Assist Devices; D006801:Humans