Clinical Requirements for Mechanical Circulatory Support Devices

As pump technology advances, the role of mechanical circulatory support (MCS) continues to expand. Whether utilized temporarily for recovery or long term to improve survival and quality of life, the goals of MCS are the same: maintain adequate end-organ perfusion, reduce myocardial oxygen demand, and provide adequate coronary perfusion. Candidates for long-term MCS should undergo a rigorous preoperative evaluation including hemodynamic factors, clinical examination, laboratory studies, and psychosocial assessment prior to device implantation. Many patient factors, particularly renal and hepatic function, may improve during long-term MCS and provide the opportunity for previously contraindicated patients to be listed for a heart transplant.