The future of durable mechanical circulatory support devices: Emerging innovations

The field of durable mechanical circulatory support (MCS) has experienced remarkable progress in both advancements in technology and patient management over the past few decades. Left ventricular assist devices have evolved from bulky, pulsatile flow devices plagued by short durability and high adverse events to compact, fully magnetically levitated, continuous flow pumps with a significantly lower risk of adverse events and providing high rates of long-term survival. Yet, multiple opportunities for refinement in pump design, patient selection, and management strategies remain. The ideal MCS device would provide untethered, physiologically responsive support, minimize need for anticoagulation, and be adaptable to a wide range of patient and cardiac anatomies. In this review, we summarize emerging technological developments within various domains of pump design which will continue to shape the future of this field.