The role of long-term mechanical circulatory support in the treatment of end-stage heart failure

Kardiol Pol. 2019;77(3):331-340. doi: 10.5603/KP.a2019.0027.

Abstract

Heart failure is a clinical syndrome of multifactorial aetiology with typical symptoms and diverse prevalence depending on the world region, reaching more than 10% in the population over 70 years of age. The prognosis, in spite of a dynamic improve- ment in medical therapy, remains poor. The only treatment for these patients is heart transplantation, however, its availability is highly limited because of the shortage of donor organs. Mechanical circulatory support can offer an alternative treatment for this patient cohort. In this review the authors discuss the present indications for, as well as results and complications of different types of long-term mechanical circulatory support. The long-term survival in patients receiving this therapy, in spite of many complication, is much better than in those receiving medical treatment. The use of mechanical circulatory support is an established treatment option for many patients with end-stage heart failure. The most important issue for the cardiologist is to identify patients eligible for this therapy in order to give them a chance for a longer life and better quality of life.

Keywords: biventricular assist device; heart failure; left ventricular assist device; mechanical circulatory support; right ventricular assist device; total artificial heart.

MeSH terms

  • Aged
  • Assisted Circulation / methods*
  • Disease Progression
  • Female
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart-Assist Devices*
  • Humans
  • Male
  • Palliative Care / methods*
  • Quality of Life
  • Stroke Volume