title: Current status of mechanical circulatory support for treatment of advanced end-stage heart failure: successes, shortcomings and needs.
abstract: Heart failure (HF) remains a major global burden in terms of morbidity and mortality. Despite advances in pharmacological and resynchronization device therapy, many patients worsen to end-stage HF. Although the gold-standard treatment for such patients is heart transplantation, there will always be a shortage of donor hearts. Areas covered: A left ventricular assist device (LVAD) is a valuable option for these patients as a bridge measure (to recovery, to candidacy for transplant, or to transplant itself) or as destination therapy. This review describes the current indications for and complications of the most commonly implanted LVADs. In addition, we review the potential and promising new LVADs, including the HeartMate 3, MVAD, and other LVADs. Studies investigating each were identified through a combination of online database and direct extraction of studies cited in previously identified articles. Expert commentary: The goal of LVADs has been to fill the gap between patients with end-stage HF who would likely not benefit from heart transplantation and those who could benefit from a donor heart. As of now, the use of LVADs has been limited to patients with end-stage HF, but next-generation LVAD therapy may improve both survival and quality of life in less sick patients.
authors.affiliation: a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Gengo
authors.initials: G
authors.lastname: Sunagawa
authors.affiliation: b Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure , Cardiac Transplantation and Mechanical Circulatory Support, Miller Family Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Marijan
authors.initials: M
authors.lastname: Koprivanac
authors.affiliation: a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Jamshid H
authors.initials: JH
authors.lastname: Karimov
authors.affiliation: a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA.|b Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure , Cardiac Transplantation and Mechanical Circulatory Support, Miller Family Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Nader
authors.initials: N
authors.lastname: Moazami
authors.affiliation: a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fukamachi
mesh_terms: D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D011788:Quality of Life
keywords: Continuous flow; heart failure; heart transplantation; mechanical circulatory support; ventricular assist device