Abstract
During the last 20 years, the management of heart failure has significantly improved by means of new pharmacotherapies, more timely invasive treatments and device assisted therapies. Indeed, advances in mechanical support, namely with the development of more efficient left ventricular assist devices (LVADs), and the total artificial heart have reduced mortality and morbidity in patients awaiting transplantation, so much so, that LVADs are now approved of as a strategy for destination therapy. In this review, the authors describe in detail the current basic indications, functioning modalities, main limitations of surgical LAVDs, total artificial heart development, and percutaneous assist devices, trying to clarify this complex, but fascinating topic.
Highlights
The prevalence of heart failure is increasing and the prognosis of advanced heart failure remains dismal.[1]
During the last 20 years, significant progress has been made in the treatment of heart failure, related to new pharmacotherapies [Angiotensin converting enzyme (ACE) inhibitors and beta-blockers], and to device therapy and invasive treatment.[2,3,4,5,6]
A strategy of heart transplantation versus left ventricular assist devices (LVADs) should be balanced against advantages and disadvantages (Table1)
Summary
The prevalence of heart failure is increasing and the prognosis of advanced heart failure remains dismal.[1] The current gold-standard therapy in advanced heart failure remains cardiac transplantation, but the eligible candidates far outnumber the available donor organs. During the last 20 years, significant progress has been made in the treatment of heart failure, related to new pharmacotherapies [Angiotensin converting enzyme (ACE) inhibitors and beta-blockers], and to device therapy and invasive treatment.[2,3,4,5,6] These advances have resulted in an improved prognosis and quality of life in patients with severe advanced heart failure. LVADs are approved for use as a strategy for destination therapy. In this comprehensive review, we present the current knowledge on cardiocirculatory assist devices: basic know-. Accepted: September 15, 2012 Published online: November 23, 2012 ledge of their functioning principles and results which should be the armamentarium of cardiovascular professionals and/ or general physicians who may be occasionally involved in the management of patients bearing such technology
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