Artificial mechanical hearts and ventricular assist devices

Mechanical circulatory support (MCS) with durable ventricular assist devices (VADs) has become an accepted therapy for advanced heart failure that is refractory to medical management. There have been many advances in the landscape of VAD technology over the past two decades. This chapter outlines clinically available solutions, clinical trials and experimental treatments, and preclinical technologies that are in development. These notable advancements in device designs have been associated with significant improvements in patient outcomes. In order for the field of MCS to evolve and become accessible to a population of patients with less-advanced heart failure, continued progress is needed to reduce the current burden of major adverse events. It is likely that in the next decade a majority of these hurdles can be overcome and that VAD therapy can expand to a broader population of patients with advanced heart failure.