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Ventricular assist devices.

Heart failure occurs in 1% of the UK adult population yet represents 5% of all hospital admissions, according to the 2008/09 National Heart Failure audit (http://www.ic.nhs.uk/ webfiles/publications/002_Audits/NHS_IC_ HEART_FAILURE_AUDIT_13-12-10.pdf ). The 3 month readmission rate is as high as 30% and 30% of patients admitted will die within 1 yr of discharge. Medical therapies, such as angiotensin-converting enzyme inhibitors, b-blockers, diuretics, inotropic agents, and anti-arrhythmics represent the usual care, but for patients with end-stage heart failure the only effective treatment is surgical intervention. In addition, cardiogenic shock associated with acute myocardial infarction, postcardiotomy and cardiomyopathies carries a high mortality if treated by conservative means alone. Ventricular assist devices (VADs) are mechanical systems that reduce the workload of the heart, permitting the ventricle to rest, whilst maintaining cardiac output and perfusion of vital organs. They have subsequently gained popularity in both acute and chronic heart failure as potentially life-saving treatment modalities.