Purpose of Review

Heart failure is an important healthcare issue because of its high prevalence, mortality, and morbidity. Advanced heart failure therapies have improved significantly over the years with improved outcomes. Heart transplantation remains an elusive treatment option for most patients; hence, the need for alternative therapy has given rise to the use of mechanical circulatory support (MCS) devices, initially as bridge to transplantation, but with more recent use as destination therapy. This review focuses on the intricacies of establishing a successful left ventricular assist device (LVAD) program for destination therapy in the setting of a growing anticipated need for wider availability of such treatment options.

Recent Findings

Guidelines have established the role of MCS in patients with advanced HF refractory to optimal guideline-directed medical therapy (GDMT) and cardiac device interventions. Multiple studies have shown generational improvement in the overall safety profile of MCS devices with the use of newer devices for destination therapy showing improved outcomes.

Summary

Heart failure is a growing cardiovascular problem with an anticipated growing need for advanced HF therapies including MCS devices. A model of shared care LVAD to destination therapy implanting site should be considered as a strategy to start a successful LVAD program.

中文翻译：

---

对目的地治疗左心室辅助装置站点的共享护理：启动成功机械循环支持计划的新策略

审查目的

心力衰竭是一个重要的医疗保健问题，因为它的患病率、死亡率和发病率都很高。多年来，先进的心力衰竭疗法有了显着改善，结果也有所改善。对于大多数患者来说，心脏移植仍然是一种难以捉摸的治疗选择。因此，替代疗法的需要引起了机械循环支持 (MCS) 装置的使用，最初作为移植的桥梁，但最近用作目的地疗法。本综述侧重于在对更广泛的此类治疗选择的预期需求不断增长的情况下，为目的地治疗建立成功的左心室辅助装置 (LVAD) 计划的复杂性。

最近的发现

指南已经确立了 MCS 在对最佳指南指导药物治疗 (GDMT) 和心脏器械干预无效的晚期 HF 患者中的作用。多项研究表明，MCS 设备的整体安全性得到了代际改进，使用更新的设备进行目的地治疗显示出更好的结果。

概括

心力衰竭是一个日益严重的心血管问题，对包括 MCS 设备在内的先进 HF 疗法的需求预计会不断增长。LVAD 到目标治疗植入部位的共享护理模型应被视为启动成功 LVAD 计划的策略。