ABSTRACT
Mechanical circulatory support for patients with cardiogenic shock is rapidly becoming an integral part of cardiac surgery. Ventricular assist device (VAD) support offers obvious benefits but is considered an expensive procedure because of device costs as well as the severe nature of the illnesses they are designed to treat. VAD support is typically used as a last ditch effort to save a patient’s life. Thus, in weighing the economic and social costs of end stage heart failure as opposed to VAD support, the following questions must be asked. Considerable progress has been made over the past decade in the development of mechanical circulatory support devices. Active cardiac centers acquire one or more VAD systems primarily for the ability to provide patients with state-of-the-art medical procedures that can offer patients the greatest chance for survival. An individual who does routine approvals according to specific guidelines and policies may deny coverage for VAD support if it is costly and an unfamiliar procedure.
