The role of mechanical circulatory support as destination therapy for ambulatory heart failure

Continuous flow technology has dramatically improved patient survival during ventricular assist device (VAD) therapy in recent years. Health-related quality of life is improved by at least two years. Despite remarkable progress in this field, major adverse events during VAD support limit the effectiveness of this therapy and present major barriers to its extension to ambulatory advanced heart failure patients. The pace of progress will depend on improvements in both the adverse event profile and development of semi-quantitative methodology to calculate and display a composite of survival and health-related quality of life.