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The Implantable Left Ventricular Assist Device: A Bridge to a Destination

Louis E. Samuels

The Implantable Left Ventricular Assist Device (LVAD) has been in clinical use for several decades, serving originally as a therapy for bridging patients to heart transplantation (BTT). For the past fifteen years, the implantable LVAD has also served as a permanent device in patients who are not eligible for cardiac transplantation— Destination Therapy (DT). Although early results were markedly superior to optimal medical management (OMM), device durability was limited. In response, improvements in patient selection and pump design have translated into improved outcomes. As such, a broader acceptance of LVAD therapy for end-stage heart failure has been observed.