Left ventricular assist as a viable alternative for cardiac transplantation.

Implantation of left ventricular assist systems (LVASs) is becoming more prevalent for patients with end-stage heart disease who are awaiting cardiac transplantation. The original intent of the LVAS was to provide an alternative to transplantation, but until recently, the LVAS has been approved only as a bridge to transplantation. Now that bridging to transplantation for patients with LVASs has exceeded 2-year periods, permanent implantation is being done as an alternative to transplantation. This article reviews the fundamental components of the HeartMate Vented Electric LVAS (Thermo Cardiosystems, Inc, Woburn, MA) with a focus on patient complications and nursing implications. Additionally, the intraoperative implantation procedure is presented. Finally, ethical and financial considerations related to permanent LVAS implantation are discussed.