Percutaneous mechanical assistance for the failing heart

One of the most challenging situations in contemporary medicine is, doubtlessly, the approach and treatment of patients presenting with severe left ventricle failure. Since its first clinical application in patients with cardiogenic shock in 1968, the intraaortic balloon pump (IABP) has been widely accepted by heart failure physicians. Although IABP therapy has been shown to be effective for the support and stabilization of hemodynamically compromised patients, it has failed to promote any improvements in patient outcomes. For this reason, much attention has been invested in the development of external devices that can collaborate with the treatment of this condition. In this context, the percutaneous left ventricle assist device (pLVAD), like TandemHeart (Cardiac Assist, Inc.; Pittsburgh, PA, USA), and, more recently, the Impella 2.5 (Abiomed Europe, Aachen, Germany) has emerged. The purpose of this review is to describe the history of pLVAD, from its beginning, to the other devices currently available, including those created for right ventricle and biventricular support.