Related Experiment Video
Updated: Mar 24, 2026
Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
Published on: May 11, 2018
Left ventricular assist device: a bridge to transplant or destination therapy?
Swati Patel1, Louise Nicholson1, Christopher J Cassidy2
1Hull York Medical School, Hull, UK.
Insights
Left Ventricular Assist Devices (LVADs) offer a promising solution for advanced end-stage heart failure when heart transplants are unavailable. Further research is needed to confirm their efficacy, safety, and cost-effectiveness as lifelong therapy.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Heart failure is a global health crisis, leading to frequent hospitalizations and significant financial strain.
- Increased life expectancy has resulted in a growing population of patients with chronic heart failure.
- Cardiac transplantation is the preferred option for severe cases, but donor heart scarcity limits its accessibility.
Purpose of the Study:
- To explore the potential of Left Ventricular Assist Devices (LVADs) as a permanent solution for advanced end-stage heart failure (ESHF).
- To evaluate LVADs as destination therapy (DT) in light of limited donor availability for cardiac transplantation.
Main Methods:
- Review of current evidence on LVADs used as destination therapy.
- Analysis of potential benefits and drawbacks compared to traditional bridge-to-transplantation use.
- Consideration of efficacy, safety, quality-adjusted life years, and cost-effectiveness.
Main Results:
- LVADs are emerging as a viable option for patients with ESHF who cannot receive a heart transplant.
- Destination therapy with LVADs presents a potential treatment avenue, but requires careful consideration.
- Further investigation is warranted regarding the long-term outcomes and economic impact of LVAD destination therapy.
Conclusions:
- LVADs offer a critical alternative for patients with advanced heart failure facing donor limitations.
- Destination therapy with LVADs shows promise but necessitates thorough evaluation of its clinical and economic implications.
- The role of LVADs in lifelong management of heart failure requires continued research and validation.
Abstract:
Heart failure is a major problem worldwide; it is the leading cause of hospitalisation and is posing a huge financial burden. Advances in healthcare have contributed to increased life expectancy, with a resultant increase in the number of patients with chronic heart failure. For many patients who are still severely symptomatic despite optimal medical therapy and cardiac resynchronisation therapy, cardiac transplantation would be the preferred treatment option. However, hopes are cut short with a limited donor pool of hearts for the increasing number of patients requiring cardiac transplantation. One uprising method to fill this treatment void for patients with advanced end-stage heart failure (ESHF) is the Left Ventricular Assist Device (LVAD). Although traditionally used as a bridge to transplantation, owing to limitation of suitable donors, evidence suggests increasing potential for the use of LVAD as destination therapy (DT), that is, lifelong permanent support. Exploration of DT is a promising avenue to many patients suffering with ESHF who may never be fortunate enough to receive a heart transplant, but not without reservations of its efficacy, safety, effects on quality-adjusted life years and cost-effectiveness, especially in comparison to heart transplantation.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:22Heart Failure VI: Adjunct Therapies