State of the Art Review: Evolution and Ongoing Challenges of Left Ventricular Assist Device Therapy

ABSTRACT Despite significant improvements in pharmacotherapy as well as coronary and electrophysiological interventions, prognosis of advanced heart failure remains poor with 1-year mortality rates as high as 25-50%. While heart transplantation remains the gold standard in the treatment of advanced heart failure, donor availability is limited, which makes it a viable option for only a minority of eligible patients. The advent of continuous-flow left ventricular assist devices (CF-LVAD) has revolutionized the treatment of advanced heart failure, and now plays a pivotal role in improving survival and quality of life of these patients. Over the past two decades, there have been significant improvements in device design and management strategies, which have led to the rapid expansion of its use for long-term support. This review examine the evolution of LVAD technology with particular attention to recent advances and ongoing challenges of device therapy.