Cardiovascular disease (CVD), as the most prevalent human disease, incorporates a broad spectrum of cardiovascular system malfunctions/disorders. While cardiac transplantation is widely acknowledged as the optional treatment for patients suffering from end-stage heart failure (HF), due to its related drawbacks, such as the unavailability of heart donors, alternative treatments, i.e., implanting a ventricular assist device (VAD), it has been extensively utilized in recent years to recover heart function. However, this solution is thought problematic as it fails to satisfactorily provide lifelong support for patients at the end-stage of HF, nor does is solve the problem of their extensive postsurgery complications. In recent years, the huge technological advancements have enabled the manufacturing of a wide variety of reliable VAD devices, which provides a promising avenue for utilizing VAD implantation as the destination therapy (DT) in the future. Along with typical VAD systems, other innovative mechanical devices for cardiac support, as well as cell therapy and bioartificial cardiac tissue, have resulted in researchers proposing a new HF therapy. This paper aims to concisely review the current state of VAD technology, summarize recent advancements, discuss related complications, and argue for the development of the envisioned alternatives of HF therapy.

References

References
1.
WHO
,
2014
, “
World Health Statistics 2014
,” World Health Organization, Geneva, Switzerland.
2.
Caballero
,
A. D.
, and
Laín
,
S.
,
2013
, “
A Review on Computational Fluid Dynamics Modelling in Human Thoracic Aorta
,”
Cardiovasc. Eng. Technol.
,
4
(
2
), pp.
103
130
.
3.
Doost
,
S. N.
,
Ghista
,
D.
,
Su
,
B.
,
Zhong
,
L.
, and
Morsi
,
Y. S.
,
2016
, “
Heart Blood Flow Simulation: A Perspective Review
,”
Biomed. Eng. Online
,
15
(
101
), pp.
1
28
.
4.
Arefin
,
M. S.
,
Awad
,
N. K.
,
Rathore
,
C. P.
,
Shukla
,
A.
, and
Morsi
,
Y. S.
,
2016
, “
Ventricular Assist Device and Its Necessity for Elderly Population
,”
Optimizing Assistive Technologies for Aging Populations
,
Y. S.
Morsi
,
A.
Shukla
, and
C. P.
Rathore
, eds.,
IGI Global
,
Hershey, PA
, pp.
314
334
.
5.
Wohlschlaeger
,
J.
,
Schmitz
,
K. J.
,
Schmid
,
C.
,
Schmid
,
K. W.
,
Keul
,
P.
,
Takeda
,
A.
,
Weis
,
S.
,
Levkau
,
B.
, and
Baba
,
H. A.
,
2005
, “
Reverse Remodeling Following Insertion of Left Ventricular Assist Devices (LVAD): A Review of the Morphological and Molecular Changes
,”
Cardiovasc. Res.
,
68
(
3
), pp.
376
386
.
6.
Garbade
,
J.
,
Bittner
,
H. B.
,
Barten
,
M. J.
, and
Mohr
,
F.-W.
,
2011
, “
Current Trends in Implantable Left Ventricular Assist Devices
,”
Cardiol. Res. Pract.
,
2011
, pp.
1
9
.
7.
Wilson
,
S. R.
,
Givertz
,
M. M.
,
Stewart
,
G. C.
, and
Mudge
,
J. G. H.
,
2009
, “
Ventricular Assist Devices: The Challenges of Outpatient Management
,”
J. Am. Coll. Cardiol.
,
54
(
18
), pp.
1647
1659
.
8.
Blaxall
,
B. C.
,
Tschannen-Moran
,
B. M.
,
Milano
,
C. A.
, and
Koch
,
W. J.
,
2003
, “
Differential Gene Expression and Genomic Patient Stratification Following Left Ventricular Assist Device Support
,”
J. Am. Coll. Cardiol.
,
41
(
7
), pp.
1096
1106
.
9.
Trochu
,
J.-N.
,
Leprince
,
P.
,
Bielefeld-Gomez
,
M.
,
Bastien
,
O.
,
Beauvais
,
F.
,
Gueffet
,
J.-P.
,
Logeart
,
D.
,
Isnard
,
R.
,
Iliou
,
M.-C.
,
Leclercq
,
C.
, and
Girard
,
C.
,
2012
, “
Left Ventricle Assist Device: When and Which Patients Should We Refer?
,”
Arch. Cardiovasc. Dis.
,
105
(
2
), pp.
114
121
.
10.
Slaughter
,
M. S.
,
Rogers
,
J. G.
,
Milano
,
C. A.
,
Russell
,
S. D.
,
Conte
,
J. V.
,
Feldman
,
D.
,
Sun
,
B.
,
Tatooles
,
A. J.
,
Delgado
,
R. M. I.
,
Long
,
J. W.
,
Wozniak
,
T. C.
,
Ghumman
,
W.
,
Farrar
,
D. J.
, and
Frazier
,
O. H.
,
2009
, “
Advanced Heart Failure Treated With Continuous-Flow Left Ventricular Assist Device
,”
N. Engl. J. Med.
,
361
(
23
), pp.
2241
2251
.
11.
Trachtenberg
,
B. H.
,
Cordero-Reyes
,
A.
,
Elias
,
B.
, and
Loebe
,
M.
,
2015
, “
A Review of Infections in Patients With Left Ventricular Assist Devices: Prevention, Diagnosis and Management
,”
Methodist DeBakey Cardiovasc. J.
,
11
(
1
), pp.
28
32
.
12.
Cheng
,
A.
,
Williamitis
,
C. A.
, and
Slaughter
,
M. S.
,
2014
, “
Comparison of Continuous-Flow and Pulsatile-Flow Left Ventricular Assist Devices: Is There an Advantage to Pulsatility?
,”
Ann. Cardiothorac. Surg.
,
3
(
6
), pp.
573
581
.
13.
Vlodaver
,
Z.
,
Wilson
,
R. F.
, and
Garry
,
D. J.
,
2012
,
Coronary Heart Disease: Clinical, Pathological, Imaging, and Molecular Profiles
,
Springer
,
New York
.
14.
Park
,
S. J.
,
Milano
,
C. A.
,
Tatooles
,
A. J.
,
Rogers
,
J. G.
,
Adamson
,
R. M.
,
Steidley
,
D. E.
,
Ewald
,
G. A.
,
Sundareswaran
,
K. S.
,
Farrar
,
D. J.
, and
Slaughter
,
M. S.
,
2012
, “
Outcomes in Advanced Heart Failure Patients With Left Ventricular Assist Devices for Destination Therapy
,”
Circ.: Heart Failure
,
5
(
2
), pp.
241
248
.
15.
Jorde
,
U. P.
,
Khushwaha
,
S. S.
,
Tatooles
,
A. J.
,
Naka
,
Y.
,
Bhat
,
G.
,
Long
,
J. W.
,
Horstmanshof
,
D.
,
Kormos
,
R. L.
,
Teuteberg
,
J. J.
,
Slaughter
,
M. S.
,
Birks
,
E. J.
,
Farrar
,
D. J.
, and
Park
,
S. J.
,
2013
, “
Two-Year Outcomes in the Destination Therapy Post-FDA-Approval Study With a Continuous Flow Left Ventricular Assist Device: A Prospective Study Using the INTERMACS Registry
,”
J. Heart Lung Transplant.
,
32
(
Suppl. 4
), p.
S10
.
16.
Frazier
,
O. H.
, and
Parnis
,
S. M.
,
2014
, “
Ventricular Assist Devices
,”
Textbook of Organ Transplantation
,
A. D.
Kirk
,
S. J.
Knechtle
,
C. P.
Larsen
,
J. C.
Madsen
,
T. C.
Pearson
, and
S. A.
Webber
, eds.,
Wiley
,
Hoboken, NJ
, pp.
554
562
.
17.
Pagani
,
F. D.
,
2008
, “
Continuous-Flow Rotary Left Ventricular Assist Devices With ‘3rd Generation’ Design
,”
Semin. Thoracic Cardiovasc. Surg.
,
20
(
3
), pp.
255
263
.
18.
Morshuis
,
M.
,
El-Banayosy
,
A.
,
Arusoglu
,
L.
,
Koerfer
,
R.
,
Hetzer
,
R.
,
Wieselthaler
,
G.
,
Pavie
,
A.
, and
Nojiri
,
C.
,
2009
, “
European Experience of Duraheart™ Magnetically Levitated Centrifugal Left Ventricular Assist System
,”
Eur. J. Cardio-Thoracic Surg.
,
35
(
6
), pp.
1020
1028
.
19.
Zhou
,
M.-D.
,
Yang
,
C.
,
Liu
,
Z.
,
Cysyk
,
J.
, and
Zheng
,
S.-Y.
,
2012
, “
An Implantable Fabry-Pérot Pressure Sensor Fabricated on Left Ventricular Assist Device for Heart Failure
,”
Biomed. Microdevices
,
14
(
1
), pp.
235
245
.
20.
Moscato
,
F.
,
Arabia
,
M.
,
Colacino
,
F. M.
,
Naiyanetr
,
P.
,
Danieli
,
G. A.
, and
Schima
,
H.
,
2010
, “
Left Ventricle Afterload Impedance Control by an Axial Flow Ventricular Assist Device: A Potential Tool for Ventricular Recovery
,”
Artif. Organs
,
34
(
9
), pp.
736
744
.
21.
Tchantchaleishvili
,
V.
,
Sagebin
,
F.
,
Ross
,
R. E.
,
Hallinan
,
W.
,
Schwarz
,
K. Q.
, and
Massey
,
H. T.
,
2014
, “
Evaluation and Treatment of Pump Thrombosis and Hemolysis
,”
Ann. Cardiothorac. Surg.
,
3
(
5
), pp.
490
495
.
22.
Givertz
,
M. M.
,
2011
, “
Ventricular Assist Devices: Important Information for Patients and Families
,”
Circulation
,
124
(
12
), pp.
e305
e311
.
23.
Molina
,
E. J.
, and
Boyce
,
S. W.
,
2013
, “
Current Status of Left Ventricular Assist Device Technology
,”
Semin. Thoracic Cardiovasc. Surg.
,
25
(
1
), pp.
56
63
.
24.
Wieselthaler
,
G. M.
,
Schima
,
H.
,
Hiesmayr
,
M.
,
Pacher
,
R.
,
Laufer
,
G.
,
Noon
,
G. P.
,
DeBakey
,
M.
, and
Wolner
,
E.
,
2000
, “
First Clinical Experience With the Debakey VAD Continuous-Axial-Flow Pump for Bridge to Transplantation
,”
Circulation
,
101
(
4
), pp.
356
359
.
25.
Hoshi
,
H.
,
Shinshi
,
T.
, and
Takatani
,
S.
,
2006
, “
Third-Generation Blood Pumps With Mechanical Noncontact Magnetic Bearings
,”
Artif. Organs
,
30
(
5
), pp.
324
338
.
26.
Chusri
,
Y.
,
Diloksumpan
,
P.
, and
Naiyanetr
,
P.
,
2013
, “
Current Left Ventricular Assist Device
,”
Sixth Biomedical Engineering International Conference
(
BMEiCON
), Krabi, Thailand, Oct. 23–25, pp.
1
4
.
27.
Loforte
,
A.
,
Montalto
,
A.
,
Ranocchi
,
F.
,
Casali
,
G.
,
Luzi
,
G.
,
Monica
,
P. L. D.
,
Sbaraglia
,
F.
,
Polizzi
,
V.
,
Distefano
,
G.
, and
Musumeci
,
F.
,
2009
, “
Heartmate II Axial-Flow Left Ventricular Assist System: Management, Clinical Review and Personal Experience
,”
J. Cardiovasc. Med.
,
10
(
10
), pp.
765
771
.
28.
Giridharan
,
G. A.
,
Lee
,
T. J.
,
Ising
,
M.
,
Sobieski
,
M. A.
,
Koenig
,
S. C.
,
Gray
,
L. A.
, and
Slaughter
,
M. S.
,
2012
, “
Miniaturization of Mechanical Circulatory Support Systems
,”
Artif. Organs
,
36
(
8
), pp.
731
739
.
29.
Timms
,
D.
,
2011
, “
A Review of Clinical Ventricular Assist Devices
,”
Med. Eng. Phys.
,
33
(
9
), pp.
1041
1047
.
30.
Farrar
,
D.
,
Bourque
,
K.
,
Reichenbach
,
S.
,
Muller
,
P.
, and
Peri
,
L.
,
2014
, “
Innovation Update
,”
Ventricular Assist Devices in Advanced-Stage Heart Failure
,
S.
Kyo
, ed.,
Springer
,
Tokyo
, Japan, pp.
131
142
.
31.
Estep
,
J. D.
,
Chang
,
S. M.
,
Bhimaraj
,
A.
,
Torre-Amione
,
G.
,
Zoghbi
,
W. A.
, and
Nagueh
,
S. F.
,
2012
, “
Imaging for Ventricular Function and Myocardial Recovery on Nonpulsatile Ventricular Assist Devices
,”
Circulation
,
125
(
18
), pp.
2265
2277
.
32.
John
,
R.
,
Naka
,
Y.
,
Smedira
,
N. G.
,
Starling
,
R.
,
Jorde
,
U.
,
Eckman
,
P.
,
Farrar
,
D. J.
, and
Pagani
,
F. D.
,
2011
, “
Continuous Flow Left Ventricular Assist Device Outcomes in Commercial Use Compared With the Prior Clinical Trial
,”
Ann. Thoracic Surg.
,
92
(
4
), pp.
1406
1413
.
33.
Bogaev
,
R.
,
Delgado
,
R.
,
Taegtmeyer
,
H.
, and
Frazier
,
O. H.
,
2011
, “
Circulatory Assist Device in Heart Failure
,”
Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine
,
B.
Robert
,
M.
Douglas
,
Z.
Douglas
, and
L.
Peter
, eds.,
Elsevier—Health Sciences Division
,
Philadelphia, PA
, pp.
818
833
.
34.
Abiomed
,
2010
, “
Impella® LD With the Impella® Console Instructions for Use & Clinical Reference Manual
,”
Abiomed, Inc.
,
Danvers, MA
.
35.
THI,
2016
, “
Tandemheart pVAD
,” Texas Heart Institute, Houston, TX, accessed Nov. 29, 2016, http://www.texasheart.org/Research/Devices/tandemheart.cfm
36.
Kar
,
B.
,
Adkins
,
L. E.
,
Civitello
,
A. B.
,
Loyalka
,
P.
,
Palanichamy
,
N.
,
Gemmato
,
C. J.
,
Myers
,
T. J.
,
Gregoric
,
I. D.
, and
Delgado
,
R. M.
,
2006
, “
Clinical Experience With the Tandemheart® Percutaneous Ventricular Assist Device
,”
Tex. Heart Inst. J.
,
33
(
2
), pp.
111
115
.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1524679/
37.
Klein
,
A. A.
,
Lewis
,
C. J.
, and
Madsen
,
J. C.
,
2011
,
Organ Transplantation: A Clinical Guide
,
Cambridge University Press
,
New York
.
38.
Gross
,
D. R.
,
1999
, “
Concerning Thromboembolism Associated With Left Ventricular Assist Devices
,”
Cardiovasc. Res.
,
42
(
1
), pp.
45
47
.
39.
Rigatelli
,
G.
,
Santini
,
F.
, and
Faggian
,
G.
,
2012
, “
Past and Present of Cardiocirculatory Assist Devices: A Comprehensive Critical Review
,”
J. Geriatr. Cardiol.
,
9
(
4
), pp.
389
400
.
40.
Anstadt
,
M. P.
,
Bartlett
,
R. L.
,
Malone
,
J. P.
,
Brown
,
G. R.
,
Martin
,
S.
,
Nolan
,
D. J.
,
Oberheu
,
K. H.
, and
Anstadt
,
G. L.
,
1991
, “
Direct Mechanical Ventricular Actuation for Cardiac Arrest in Humans: A Clinical Feasibility Trial
,”
Chest
,
100
(
1
), pp.
86
92
.
41.
Mau
,
J.
,
Menzie
,
S.
,
Huang
,
Y.
,
Ward
,
M.
, and
Hunyor
,
S.
,
2011
, “
Nonsurround, Nonuniform, Biventricular-Capable Direct Cardiac Compression Provides Frank-Starling Recruitment Independent of Left Ventricular Septal Damage
,”
J. Thoracic Cardiovasc. Surg.
,
142
(
1
), pp.
209
215
.
42.
Abiomed,
2014
, “
Abiocor® Implantable Replacement Heart Instructions for Use
,” Abiomed, Inc., Danvers, MA, accessed Dec. 19, 2014, https://www.fda.gov/ohrms/dockets/ac/05/briefing/2005-4149b2_01_ABIOMED%20INSTRUCTIONS%20FOR%20USE.pdf
43.
Boccaccio
,
A.
,
Carbone
,
C.
,
Galietti
,
U.
,
Mastropasqua
,
F.
, and
Pappalettere
,
C.
,
2011
, “
A Novel Electro-Mechanical Ventricular Assist Device for Refractory Cardiac Insufficiency
,”
IEEE International Workshop on Medical Measurements and Applications
(
MeMeA
), Bari, Italy, May 30–31, pp.
221
224
.
44.
Starling
,
R. C.
, and
Jessup
,
M.
,
2004
, “
Worldwide Clinical Experience With the Corcap™ Cardiac Support Device
,”
J. Card. Failure
,
10
(
Suppl. 6
), pp.
S225
S233
.
45.
Trumble
,
D. R.
,
McGregor
,
W. E.
,
Kerckhoffs
,
R. C. P.
, and
Waldman
,
L. K.
,
2011
, “
Cardiac Assist With a Twist: Apical Torsion as a Means to Improve Failing Heart Function
,”
ASME J. Biomech. Eng.
,
133
(
10
), p.
101003
.
46.
Sales
,
V.
, and
McCarthy
,
P.
,
2010
, “
Understanding the C-Pulse Device and Its Potential to Treat Heart Failure
,”
Curr. Heart Failure Rep.
,
7
(
1
), pp.
27
34
.
47.
Lowe
,
J. E.
,
Anstadt
,
M. P.
,
Van Trigt
,
P.
,
Smith
,
P. K.
,
Hendry
,
P. J.
,
Plunkett
,
M. D.
, and
Anstadt
,
G. L.
,
1991
, “
First Successful Bridge to Cardiac Transplantation Using Direct Mechanical Ventricular Actuation
,”
Ann. Thoracic Surg.
,
52
(
6
), pp.
1237
1245
.
48.
Anstadt
,
M. P.
,
Anstadt
,
G. L.
, and
Lowe
,
J. E.
,
1991
, “
Direct Mechanical Ventricular Actuation: A Review
,”
Resuscitation
,
21
(
1
), pp.
7
23
.
49.
Criscione
,
J. C.
,
Biswas
,
S.
,
Hall
,
S.
,
Harrison
,
L.
, and
Robbins
,
D.
,
2011
, “
Device for the Modulation of Cardiac End Diastolic Volume
,” The Texas A&M University System/Corinnova Incorporated, College Station, TX/Houston, TX, U.S. Patent No.
US7871366 B2
http://www.google.com/patents/US7871366.
50.
Blom
,
A.
,
Pilla
,
J.
,
Gorman
,
R.
, III
,
Gorman
,
J.
,
Mukherjee
,
R.
,
Spinale
,
F.
, and
Acker
,
M.
,
2005
, “
Infarct Size Reduction and Attenuation of Global Left Ventricular Remodeling With the CorCapTM Cardiac Support Device Following Acute Myocardial Infarction in Sheep
,”
Heart Failure Rev.
,
10
(
2
), pp.
125
139
.
51.
Konertz
,
W. F.
,
Shapland
,
J. E.
,
Hotz
,
H.
,
Dushe
,
S.
,
Braun
,
J. P.
,
Stantke
,
K.
, and
Kleber
,
F. X.
,
2001
, “
Passive Containment and Reverse Remodeling by a Novel Textile Cardiac Support Device
,”
Circulation
,
104
(
Suppl. 1
), pp.
I-270
I-275
.
52.
Morsi
,
Y. S.
,
2014
, “
Bioengineering Strategies for Polymeric Scaffold for Tissue Engineering an Aortic Heart Valve: An Update
,”
Int. J. Artif. Organs
,
37
(
9
), pp.
651
667
.
53.
Brown
,
M. A.
,
Iyer
,
R. K.
, and
Radisic
,
M.
,
2008
, “
Pulsatile Perfusion Bioreactor for Cardiac Tissue Engineering
,”
Biotechnol. Prog.
,
24
(
4
), pp.
907
920
.
54.
Yildirim
,
Y.
,
Naito
,
H.
,
Didié
,
M.
,
Karikkineth
,
B. C.
,
Biermann
,
D.
,
Eschenhagen
,
T.
, and
Zimmermann
,
W.-H.
,
2007
, “
Development of a Biological Ventricular Assist Device: Preliminary Data From a Small Animal Model
,”
Circulation
,
116
(
Suppl. 11
), pp.
I-16
I-23
.
55.
Reis
,
L. A.
,
Chiu
,
L. L. Y.
,
Feric
,
N.
,
Fu
,
L.
, and
Radisic
,
M.
,
2016
, “
Biomaterials in Myocardial Tissue Engineering
,”
J. Tissue Eng. Regener. Med.
,
10
(
1
), pp.
11
28
.
56.
Krishna
,
K. A.
,
Krishna
,
K. S.
,
Berrocal
,
R.
,
Rao
,
K. S.
, and
Sambasiva Rao
,
K. R. S.
,
2011
, “
Myocardial Infarction and Stem Cells
,”
J. Pharm. Bioallied Sci.
,
3
(
2
), pp.
182
188
.
You do not currently have access to this content.