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More than 5 million people carry the diagnosis of heart failure in USA and almost 300,000 people die of heart failure each year in USA1. Heart failure remains the most common discharge diagnosis for patients older than 65 years of age. In the Western world, most heart failure is related to coronary disease, and although the survival of patients post acute myocardial infarction has improved, this has resulted in an increase in the number of patients ultimately developing heart failure2. Advances in medical therapy have resulted in improved survival in patients with moderate and severe heart failure, but the prognosis for end-stage heart failure patients remains poor3-5. In patients with end-stage heart failure cardiac transplantation remains the gold standard of cardiac replacement therapy and it has shown the greatest survival benefit. However, the supply of donor hearts is limited. There is also an increase in the number of heart failure patients who are not candidates for cardiac transplantation, mainly due to older age and presence of co-morbidities. There has therefore been considerable interest in alternative forms of cardiac replacement therapy, either as a temporary bridge to transplantation or as a definitive destination strategy. Multiple different mechanical devices for long-term circulatory support have been developed, ranging from total artificial hearts to ventricular assist devices (VADs). The main purpose of a VAD is to unload the failing heart and help maintain forward cardiac output and vital organ perfusion. Originally introduced as a temporary bridge to recovery and then as a bridge to transplantation, VADs have evolved into permanent or “destination” therapy for a growing number of patients with refractory heart failure6.

Ventricular Assist Device: Emerging Modality for Long Term Cardiac Support