Heart transplantation vs long-term mechanical assist devices: clinical equipoise?

Long-term continuous-flow left ventricular assist devices (LVAD) as bridge to heart transplantation.

Heart transplantation (HTx) is the treatment of choice for end-stage heart failure but the limited availability of heart's donors still represents a major issue. So long-term mechanical circulatory support (MCS) has been proposed as an alternative treatment option to assist patients scheduled on HTx waiting list bridging them for a variable time period to cardiac transplantation-the so-called b...

Heart Failure and Mechanical Circulatory Assist Devices

During the last 20 years, the management of heart failure has significantly improved by means of new pharmacotherapies, more timely invasive treatments and device assisted therapies. Indeed, advances in mechanical support, namely with the development of more efficient left ventricular assist devices (LVAD), and the total artificial heart have reduced mortality and morbidity in patients with end...

Long-term ventricular assist devices in current clinical practice.

Devices and clinical trials: overview and equipoise.

n an ideal world, our decision to enroll patients in clinical trials would be based on thoughtful, rational, informed, and balanced considerations of available and relevant scientific and clinical data. In reality, our decision making is based more often on our recent clinical experience and the opinions of those clinicians we value. To increase the appropriate and thoughtful enrollment of pati...

Control of Heart Assist Devices

In this paper, we discuss several control techniques for Ventricular Assist Devices (VADs) and describe a hierarchical control structure that can be used to regulate the operation of a turbo-hydrodynamic VAD. Early assist devices were pulsatile, and control usually focused on regulating flow, atrial and/or arterial pressures. In recent years, non-pulsatile turbo-hydronamic devices have been int...