title: Challenges faced in long term ventricular assist device support.
abstract: BACKGROUND
  The development of ventricular assist device (VAD) has been one of the revolutionary advancements in end-stage heart failure management. Although the device has developed and improved significantly over the last few decades, we still face multiple challenges.
  
  
  METHODS
  This review will discuss quality of life, survival, and clinically encountered complications in patients with VAD support. The literature was extensively reviewed for studies describing the above topic area. We describe the impact of major challenges faced in VAD support and discuss their future and expectations. Expert commentary: The technological advancement of VADs has contributed to major improvement of overall survival, enhancement of quality of life and decrease of incidence of complications. It is expected that technologies will continue to evolve. At the same time, the indications for and timing of device implantation, and selection of device type are continuously important in clinical practice setting.
authors.affiliation: a Department of Surgery, Division of Cardiothoracic Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Ikegami
authors.affiliation: a Department of Surgery, Division of Cardiothoracic Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Kurlansky
authors.affiliation: a Department of Surgery, Division of Cardiothoracic Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Koji
authors.initials: K
authors.lastname: Takeda
authors.affiliation: a Department of Surgery, Division of Cardiothoracic Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Naka
mesh_terms: D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D011788:Quality of Life; D016019:Survival Analysis; D013997:Time Factors
keywords: End-stage heart failure; complications; long term; mechanical cardiac support; outcome; postoperative management; ventricular assist device