Current status of left ventricular assist devices: the role in bridge to heart transplantation and future perspectives.

Increasing numbers of patients with end-stage heart failure are awaiting heart transplantation worldwide. Left ventricular assist systems have been applied to these patients with increasing frequency and support duration. This situation calls for more reliably applied long-term support devices and is also stimulating the investigation of destination therapy or bridge to recovery use of the device. This is particularly relevant in countries where organ shortages are crucial. However, reports in this area are still limited, and there exist several problems to be solved before wider application of these strategies is possible in clinical practice. We review currently available devices with special reference to their respective roles and limitations quoting our own experiences over the past several years, and discuss future perspectives of ventricular assist devices.