Durable left ventricular assist devices – the minimum for referring cardiologists

Growing population of advanced heart failure patients represents one of the major burden for health care system. Heart transplantation is the gold standard for a severe HF but contraindications and lack of donors are ultimate hurdles for its widespread use. Heart replacement using durable mechanical circulatory support, e.g. continuous-flow left ventricular assist devices (LVAD), has grown fast in recent years. It is reasonable to assume that the number of LVAD implantations will continue to grow and will soon exceed the number of HTx. The review is intended to provide essential information on the results of clinical trials with continuous flow left ventricular assist devices, indications and implantation timing. General and specific risks of LVAD surgery, short and long term courses are described, and risk assessment is outlined.