Existing issues and valid concerns in continuous-flow ventricular assist devices

Through concerted endeavours in the fields of surgery, medicine, and biomedical engineering, patronized by government and industry, ventricular assist devices have become an established surgical treatment to support the failing heart, which could easily and simply surpass the frequency of heart transplantation. Be it as it may, complications and adverse events have unfolded, and these facilitated the way to newer biomedically-engineered pump designs in search of the perfect support for a failing heart. Areas covered: This review focuses on the evolution of the continous-flow ventricular assist device as an accepted mode of treatment in advanced heart failure, as a bridge to myocardial recovery, as a bridge to heart transplantation and as a permanent therapy, with its attendant complications and long-term outcome. Expert commentary: Continuous flow devices offer improved durability, less surgical trauma due to their smaller size, high-energy efficiency, and lower thrombogenicity, regardless of administration of single or dual anti-thrombotic therapy. These benefits translate into better survival, lower frequency of adverse events, improved quality of life and higher functional capacity of patients. Through ceaseless innovations and technology, newer pumps have been developed; however, none has been proven to be superior over the others.