Left Ventricular Assist Devices

Left ventricular assist devices (LVADs) have become the standard of care for potential heart transplant patients with life-threatening heart failure refractory to medical therapy. Significant advances in both the technology and the clinical experience have taken place. In addition, indications for placement of ventricular assist devices (VADs) have broadened to include patients previously thought unsuitable for device insertion. There is a wide array of devices available and in development. These range from univentricular percutaneous driveline-powered devices to fully implantable total artificial hearts (TAHs). Both patient and device selection have a great impact on outcome. In addition, the improving long-term success with device support has led to the possibility of permanent support. This review describes indications for VAD placement, reviews current devices, and discusses postoperative management.