The next decade in mechanical assist: advances that will help the patient and the doctor.

PURPOSE OF REVIEW

Significant technological advances have occurred in mechanical assist devices over the past decade. With improving hemodynamics and durability, ventricular assist devices (VADs) are being implanted with increasing frequency. Yet, several VAD-specific morbidities and technological challenges, which are reviewed, continue to limit the number of devices that are currently implanted.

RECENT FINDINGS

We are beginning to understand the pathophysiology of complications specific to continuous-flow VADs, including bleeding and aortic insufficiency. Improved outcomes and durability with currently available continuous-flow VADs are evident, as compared with first-generation devices. A focus on enhancing quality of life with a VAD will be critical to widespread application of mechanical circulatory support to the heart failure patient population.

SUMMARY

Advances in technology and surgical technique are continuing to minimize morbidity and mortality associated with mechanical assist devices. Continued technological advancements will allow increased utilization of mechanical circulatory support over the next decade.