Implantable left ventricular assist system.

The first clinical application of the first-generation pulsatile implantable left ventricular assist system (LVAS) was in the mid 1980 s as a bridge to transplantation and contributed to an advancement of this field from a clinical experiment to an established therapeutic option for treating advanced heart failure patients. However, there have been technological limitations that have surfaced as longer-term experience has been gained. These include a high incidence of thromboembolic complications, infection, mechanical failures associated with moving parts, and the large size of both implantable pump and percutaneous cable. In order to overcome the limitations of the first-generation pulsatile LVAS, a smaller rotary blood pump LVAS emerged as a possible alternative in the 1990 s and these new generation LVAS are in various stages of development and clinical application. This article reviews the history and current status of the implantable LVAS.