[Mechanical circulatory support and replacement in heart failure].

MECHANICAL CIRCULATORY SUPPORT AND REPLACEMENT IN HEART FAILURE. Technological developments have led to a panel of mechanical devices making possible circulatory support and cardiac replacement in patients with heart failure. Some devices (namely extracorporeal membrane oxygenation or ECMO) allow short-term support in patients with acute heart failure and improve the prognosis. Other devices (left ventricular assist device and total artificial heart) are designed for long-term use in patients with advanced heart failure; although heart transplantation remains the gold standard for these patients, mechanical support devices may keep patients alive until transplantation or become destination therapy if transplantation is contraindicated. The optimal use of mechanical circulatory support needs a strong organizational network of specialized multidisciplinary centers.