ABSTRACT
In the USA, more than 4000 patients are listed for heart transplantation; 30% of them will die before a suitable donor is found. Since the donor population is not expanding, there has been a need for the development and use of mechanical circulatory assist devices to prolong survival during the wait for definitive treatment. A large number of mechanical circulatory assist devices are available and can provide extended hemodynamic support for patients deteriorating acutely or chronically while waiting for a definitive treatment. In particular, implantable ventricular assist devices (VADs) have been shown to offer extended support, even for long periods of time, for patients hemodynamically deteriorating to a stage where it would be unlikely for them to survive until transplantation. In select individuals suffering from shock after acute myocardial infarction (MI) or myocarditis, insertion of mechanical support can allow recovery of the injured heart such that primary responsibility for hemodynamic support can ultimately once again be carried out by the heart: relieving pressure and stress-load burdens from the injured myocardium might be therapeutic in and of itself.
