title: To ventricular assist devices or not: When is implantation of a ventricular assist device appropriate in advanced ambulatory heart failure?
abstract: Advanced heart failure has been traditionally treated via either heart transplantation, continuous inotropes, consideration for hospice and more recently via left ventricular assist devices (LVAD). Heart transplantation has been limited by organ availability and the futility of other options has thrust LVAD therapy into the mainstream of therapy for end stage heart failure. Improvements in technology and survival combined with improvements in the quality of life have made LVADs a viable option for many patients suffering from heart failure. The question of when to implant these devices in those patients with advanced, yet still ambulatory heart failure remains a controversial topic. We discuss the current state of LVAD therapy and the risk vs benefit of these devices in the treatment of heart failure.
authors.affiliation: Emily Cerier, Asia McDavid, Ahmet Kilic, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
authors.forename: Emily
authors.initials: E
authors.lastname: Cerier
authors.affiliation: Emily Cerier, Asia McDavid, Ahmet Kilic, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Lampert
authors.affiliation: Emily Cerier, Asia McDavid, Ahmet Kilic, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
authors.forename: Arman
authors.initials: A
authors.lastname: Kilic
authors.affiliation: Emily Cerier, Asia McDavid, Ahmet Kilic, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
authors.forename: Asia
authors.initials: A
authors.lastname: McDavid
authors.affiliation: Emily Cerier, Asia McDavid, Ahmet Kilic, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
authors.forename: Salil V
authors.initials: SV
authors.lastname: Deo
authors.affiliation: Emily Cerier, Asia McDavid, Ahmet Kilic, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kilic
keywords: Cardiomyopathy; Diastolic dysfunction; Heart failure; Left ventricular assist device; Mechanical circulatory support