Pulsatile left ventricular assist devices: what is the role in the modern era?

With the widespread use of continuous-flow ventricular assist devices (VADs), the role of pulsatile VADs remain in question. In acute cardiogenic shock, pulsatile VADs maximize perfusion pressure, restore end organ perfusion, and maximally unload the pulmonary circulation and right heart. In addition, pulsatile left VADs allow for easy conversion to biventricular support using one platform, in the case of acute right ventricular failure. Pulsatile VADs still have a major role in the treatment of acute cardiogenic shock.