Ventricular assist device for advanced heart failure

Abstract

Heart failure (HF) continues to be a highly prevalent disease, affecting 1–2% of the population in developed countries, therefore constitutes a health problem due to its high cost. Despite the progress made in drug treatment and implantation devices, the prognosis is poor. About 5% of patients diagnosed with heart failure are in advanced stage or stage D. Heart transplantation (HT) has become the preferred treatment for this high-risk group in the past 30 years. Unfortunately, in addition to the limitation of the current shortage of donors, there is only a limited number of patients meet the appropriate age and with the absence of comorbidities necessary to access this treatment. Due to this and the long waiting lists worldwide, the development and use of ventricular assist devices (VAD) are increasing. In view of the quality of life of patients with this serious disease, these devices improve the short-term and long-term survival rate and gradually reduce the complication rate. These benefits not only provide a choice for patients waiting for HT, but also give those with reversible contraindications the time and opportunity to become suitable candidates or, if impossible, eventually use it as a target treatment. However, these devices have many limitations: their cost, durability, incidence of complications and their limited application. Technological advances in mitigating complications, increased experience in management centers and their promotion to reduce costs are strategies that will continue to strengthen the use of VAD in patients with advanced heart failure.