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Destination therapy: does progress depend on left ventricular assist device development?

Manuel Prinz von Bayern1, Martin Cadeiras, Mario C Deng

  • 1College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.

Heart Failure Clinics
|August 29, 2007
PubMed
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Mechanical circulatory support devices have advanced, reducing adverse events but showing only minor survival gains. This review focuses on left ventricular assist devices as destination therapy for end-stage heart failure.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Mechanical circulatory support (MCS) devices have seen rapid evolution over the past 20 years.
  • Recent advancements have focused on reducing adverse events associated with MCS therapy.
  • Current observational data indicate limited improvements in patient survival despite technological progress.

Purpose of the Study:

  • To review the development of MCS devices, particularly left ventricular assist devices (LVADs).
  • To discuss the role of LVADs as a "destination therapy" option.
  • To explore the implications for patients with end-stage heart failure ineligible for transplantation.

Main Methods:

  • Review of published observational data on MCS devices.
  • Analysis of trends in adverse event rates and survival outcomes.

Related Experiment Videos

  • Discussion of the evolution of LVADs as a therapeutic strategy.

    • Main Results:

    • MCS device development has led to decreased adverse event rates.
    • Published observational data show only marginal improvements in survival.
    • The concept of "destination therapy" is increasingly relevant for LVADs.

    Conclusions:

    • While adverse events have decreased, significant survival improvements with MCS remain limited.
    • Left ventricular assist devices are a crucial consideration for end-stage heart failure patients.
    • Further research is needed to optimize MCS therapy and improve long-term outcomes.