ABSTRACT
Surgically implanted Left Ventricular Assist Devices (LVADs) are an integral component
of managing patients with advanced heart failure awaiting cardiac transplantation (1).
Implantable LVADs, despite the recent successes in long-term use of these devices (2),
generally continue to function as “bridge to therapy”. Mechanical support of left
ventricular function results in myocardial unloading, decrease in myocardial oxygen
demand and augmentation of coronary and systemic perfusion. It can normalize the
hemodynamic derangement of heart failure and serve as a bridge to cardiac
transplantation, recovery or even become a destination therapy. Cardiac transplantation
remains the destination therapy and patients receive LVADs only after careful planning
and patient selection. LVADs are costly, invasive and require considerable surgical
expertise for their insertion and management. They remain the domain of specialized
centers and are not widely available. They are not practical in situations where circulatory
support is needed emergently and transiently.
