Left Ventricular Assist Devices: Bridges to Transplantation, Recovery, and Destination for Whom?

Lynne Warner Stevenson, Eric A. Rose

Research output: Contribution to journalShort surveypeer-review

97 Scopus citations

Abstract

We are entering an era in which long-term mechanical circulatory support will likely play an increasing role in the approach to end-stage heart disease. The extension of mechanical circulatory support devices into destination therapy has revealed the limitations of our understanding of these populations. Current candidates for benefit from these devices demonstrate progression of disease beyond the scope of current medical therapy as provided in experienced centers, with estimated 50% mortality at 6 months. The recent REMATCH trial doubled 1-year survival to that of ambulatory class IV patients on oral therapy, providing a benchmark for future progress. Trials of devices for end-stage disease require innovative design. As devices and techniques continue to improve, benefit for both survival and function may be demonstrated in patients with decreasing severity of disease. Acceptance of devices presents societal challenges for equitable health resource allocation.

Original languageEnglish
Pages (from-to)3059-3063
Number of pages5
JournalCirculation
Volume108
Issue number25
DOIs
StatePublished - 23 Dec 2003
Externally publishedYes

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