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Mechanical circulatory support in advanced heart failure #205, 2nd ed.

About 250,000 Americans have end-stage heart failure, meaning they cannot carry out any physical activities without discomfort (dyspnea or angina) and are potentially eligible for advanced therapy such as transplantation. Less than 1% of patients, however, will receive a heart transplant. The left ventricular assist device (LVAD) was initially designed as an implanted mechanical circulatory support (MCS) to extend the life of patients awaiting heart transplants (“bridge-to-transplantation” (BTT)). In 2002, the FDA approved the LVAD not only as BTT, but also as “destination therapy” (DT) where the patient would keep the device for life, with no expectation of heart transplantation.