Alive Without a Pulse: Evolution of Durable Left Ventricular Assist Devices

Durable left ventricular assist devices (LVADs) offer a viable option for patients with advanced heart failure and have been demonstrated to be superior to optimal medical therapy in terms of both mortality and quality of life, in selected patients. However, durable LVADs can be associated with severe morbidity. Because the rates of cardiac transplantation are limited by supply, understanding of the evolution of durable LVAD support is necessary to drive innovations to optimize outcomes. Herein, we review progress in durable LVAD support in contemporary practice and propose future directions that will require additional study.