Ramping up evidence-based ventricular assist device care.

Over the past several decades, mechanical circulatory support has become an increasingly important treatment for patients with advanced heart failure. Initial proof-of-concept trials focused on reducing the mortality of critically ill patients in cardiogenic shock. Although the ultimate goal of mechanically assisted circulation was always long-term support as an alternative to cardiac transplantation, uncertainties about the durability of device performance and adverse events led to its early use in transplant candidates to provide a “bail-out” strategy in the event of device malfunction.