Abstract
The Implantable Left Ventricular Assist Device (LVAD) has been in clinical use for several decades, serving originally as a therapy for bridging patients to heart transplantation (BTT). For the past fifteen years, the implantable LVAD has also served as a permanent device in patients who are not eligible for cardiac transplantation— Destination Therapy (DT). Although early results were markedly superior to optimal medical management (OMM), device durability was limited. In response, improvements in patient selection and pump design have translated into improved outcomes. As such, a broader acceptance of LVAD therapy for end-stage heart failure has been observed.
Highlights
The desire to replace or assist the failing heart has been a challenge for more than half a century
In the 1990’s, the Heartmate LVADTM made its debut, receiving FDA approval in its pneumatic and electric versions as a BTT device [4,5]. The uniqueness of this technology was based upon a bioengineering breakthrough in the form of a textured lining to the bloodpump which eliminated the need for anticoagulation
In terms of a permanent therapy for patients ineligible for transplant, two landmark trials were undertaken around the turn of the millenium: the AbioCorTM totally implantable pulsatile electric artificial heart trial and the REMATCH Trial [6,7]
Summary
The desire to replace or assist the failing heart has been a challenge for more than half a century. In the 1990’s, the Heartmate LVADTM made its debut, receiving FDA approval in its pneumatic and electric versions as a BTT device [4,5]. The uniqueness of this technology was based upon a bioengineering breakthrough in the form of a textured lining to the bloodpump which eliminated the need for anticoagulation. In terms of a permanent therapy for patients ineligible for transplant, two landmark trials were undertaken around the turn of the millenium: the AbioCorTM totally implantable pulsatile electric artificial heart trial and the REMATCH Trial [6,7]
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