Management of acute and chronic heart failure with left ventricular assist devices.

The prevalence and incidence of heart failure is on the rise. Due to the lack of donor organs, cardiac transplantation can have only a minimal epidemiologic impact. Advances in left ventricular assist device development and experience with management and surgical implantation techniques have slowly improved the field, and the use of these devices to treat severe heart failure is gaining acceptance. The Texas Heart Institute has remained at the forefront of artificial heart research, currently utilizing both short- and long-term devices as bridge-to-transplant, bridge-to-recovery, or destination therapy. These devices provide varying degrees of support and, depending on their design, are implanted either surgically in the operating room or percutaneously in the cardiac catheterization laboratory. Despite the remarkable progress in left ventricular assist device development, there are several improvements to be made that may potentially increase their acceptance by patients and referring doctors.